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The heart has four valves, mitral, aortic, tricuspid, and pulmonary, that regulate the flow of blood through the heart's four chambers. Each valve consists of flaps, or leaflets, that function to regulate blood flow to adjacent chambers, closing tightly to prevent blood from flowing backwards. Valves can experience leakage, or regurgitation, a situation in which valves do not completely close, allowing blood to flow in reverse. A second valve disorder is stenosis, in which the valve narrows, limiting the volume of blood flow. Both conditions can significantly diminish the heart's ability to pump blood. In many cases, heart valve disease progresses slowly, as the heart compensates for irregularities in blood flow, so symptoms may not reflect the severity of heart valve disease. One may be symptom-free yet have serious heart valve disease, requiring immediate treatment. In general, faulty valves create abnormal heart sounds, such as murmurs and clicks, that can be heard with a stethoscope. An echocardiogram may be called for in order to confirm the diagnosis. Further diagnostic information can be obtained with CT-angiography and cardiac MRI.

Coronary artery disease occurs when the coronary arteries become hardened and narrowed, due to the buildup of fatty deposits known as atherosclerosis. As plaque accumulates on the arterial walls, the arteries grow narrower, restricting the flow of blood and starving the heart muscle of life-giving oxygen. A critical side-effect of atherosclerosis may be the formation of an aortic aneurysm, the abnormal enlargement in the wall of the aorta. The aneurysm typically is located along a weakened portion of the artery's wall, causing it to bulge outward. If left untreated, an aortic aneurysm may rupture, causing serious complications such as internal bleeding.

Blood, Heart and Circulation Topics

Heart disease is a condition where the heart muscle grows progressively weaker, and cannot pump enough blood to meet the body's needs for oxygen and nutrients. Heart damage can result from a variety of conditions, but the single most common cause is a heart attack that damages the heart muscle. Failure can also stem from problems with the heart's valves, rheumatic heart disease, bacterial infections, and congenital defects. Other heart diseases include abnormal heart rhythms, deterioration of the heart muscle, and high blood pressure. As heart failure progresses, blood backs up into the vessels around the lungs. This causes fluid to seep into the respiratory tract, congesting the lungs and making breathing difficult. Thus, heart failure is sometimes called congestive heart failure. Other symptoms of heart failure are fatigue, swelling of the legs, rapid weight gain, loss of appetite, abdominal bloating, and difficulty sleeping.

Open Heart Surgery

In the case of an emergency, surgical intervention may be required. Minimally invasive bypass surgery offers an alternative to coronary artery bypass grafts, for patients who have only one or two blocked arteries. This operation uses a combination of small holes in the chest, and a small incision made directly over the coronary artery that needs to be bypassed. The result is more rapid healing of the chest incision with less pain and scarring. Heart valve replacement surgery also has become a common operation in hospitals. There are many reasons why a heart valve may not be working as well as it should. Valves that are seriously degenerated can be removed surgically and replaced with a new valve mechanism.

Coronary artery bypass surgery is used to reduce the symptoms of coronary artery disease and to prevent future heart attacks in patients who have major blockages in their coronary arteries. These blockages are the result of atherosclerosis, a condition which causes fatty deposits to build up in the arteries, slowing the flow of blood. Over time, as the coronary arteries continue to narrow, angina, pain or discomfort in the chest, or a heart attack can result. Coronary artery bypass surgery uses vein grafts taken from a patient's leg, arm or inside the chest to create a detour so blood can go around the blockages in the coronary artery and reach the heart.

    source:   National Library of Medicine

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