Heart valve leak, woman sleeps sitting up to avoid shortness of breath

Ho Chi Minh City Mrs. Vinh, 68 years old, chest pain, shortness of breath, fatigue, has to sleep sitting up due to heart valve regurgitation, heart failure.

A doctor at a Ha Tinh hospital diagnosed Ms. Hoang Thi Vinh with severe mitral valve stenosis and regurgitation, moderate aortic valve regurgitation, and indicated early valve replacement. Ms. Vinh was scheduled for surgery. However, the disease progressed, making her more tired and short of breath, even having to sleep sitting up, so she went to Tam Anh General Hospital in Ho Chi Minh City for examination.

On October 24, Dr. Nguyen Anh Dung, Head of the Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, said that in addition to valvular stenosis and regurgitation, Ms. Vinh also had complications of moderate to severe heart failure (grade II-III) and atrial fibrillation. Impaired heart function affects overall health as well as impairs the function of other organs such as the liver, kidneys, etc., with the risk of death if treatment is delayed. Arrhythmia also creates conditions for blood clots to form, causing coronary artery occlusion, cerebral vascular occlusion leading to myocardial infarction and stroke.

In cases where there are no symptoms, mild stenosis or regurgitation of the heart valve, surgery is not required, but monitoring is needed to prevent the disease from progressing. When the patient has a severe mitral valve stenosis, the doctor considers balloon valvuloplasty, which does not require surgery. However, Ms. Vinh cannot have valvuloplasty because she is old, has a calcified valve, and has regurgitation, so the only treatment is valve replacement, said Dr. Dung.

The patient's aortic valve was severely damaged despite moderate regurgitation, but the consulting doctors decided to replace the entire aortic valve to avoid the risk of having to have surgery again in the following years.

One week after the surgery, Ms. Vinh no longer had difficulty breathing or chest pain, her heart rate was stable, and she was discharged from the hospital.

Ms. Vinh (middle) with her relatives on the day of discharge. Photo: Tam Anh Hospital — Ms. Vinh (middle) with her relatives on the day of discharge. Photo: *Tam Anh Hospital*

The heart has four valves, the mitral valve, tricuspid valve, pulmonary valve, and aortic valve, which are responsible for keeping blood flowing in one direction through the heart. Narrowed valves reduce the amount of blood needed through the heart chambers. Conversely, leaky valves cause blood to flow back into the heart chambers instead of being pumped to nourish the body. This condition, if prolonged, can lead to complications such as heart failure, dilated heart chambers, arrhythmias, and stroke.

Dr. Dung said that replacing two heart valves in one surgery for severe heart failure is a major surgery, with many potential risks during and after surgery such as infection, heavy bleeding, arrhythmia, myocardial infarction, stroke, and even death.

Doctors limit multiple heart surgeries in a short period of time. However, in many cases of simultaneous stenosis or leakage of multiple valves like Ms. Vinh, if the doctor does not properly assess the valve damage and only replaces one valve, there is a high possibility that the patient will have to have another surgery 1-2 years later to replace the other valves. A second heart surgery is more difficult, and the patient has a high risk of death.

After surgery, the patient needs to rest for at least 4 weeks, eat a nutritious diet, do light physical exercise, and take medication as directed by the doctor. After 4-6 weeks, the patient can return to work, from light to moderate. In addition, the patient needs regular check-ups and lifelong monitoring.

Thu Ha

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