Dr. Nicholas Pegge : Cardiologist


Symptoms of heart valve problems may range from none at all, to mild restriction of exercise from breathlessness or chest pain, to (in more advanced cases) swelling up and water retention (oedema) and breathlessness even at rest.

Most heart valve problems seen in routine cardiological practice develop in mid to later years, from thickening and stiffening of heart valve leaflets. Sometimes, individuals are born with heart valve problems, or floppy valves; some are caused by exposure to rheumatic fever in childhood or early adulthood, and occasionally some valve problems are caused by exposure to drugs.

Heart valve trouble can cause pressure on the heart either by leaking, or by not opening properly. When a valve allows a significant amount of blood to leak back in the wrong direction in the circulation, the heart has to pump more volume of blood on each beat than it would under normal circumstances. As a consequence, the heart may enlarge to accommodate the extra volume load.

In contrast, a stiff and narrow valve restricts the flow of blood from the heart, and the heart muscle may thicken in order to pump at higher and higher pressure to get enough blood to flow through the obstructed valve.

Either situation may cause breathlessness or palpitations or in time, fluid retention. Narrowed heart valves cause chest pain, dizzy spells or blackout more commonly than leaking valves.

If untreated, certain valve problems may take years off a patient’s life expectancy: thi is perhaps particularly the case for aortic stenosis.

Investigations may include echocardiography, both by the transthoracic route and by transoesophageal, and sometimes with addition of stress testing with drug or exercise; cardiac catheterisation; cardiac MRI; CT scanning.











All information on this website has been written by
Dr Nicholas Pegge MA (Cantab.) MB BS (London) FRCP