Valvular Heart Disease (VHD) refers to a group of conditions in which one or more of the heart valves—the aortic, mitral, tricuspid, or pulmonary valves—do not function properly. Healthy heart valves ensure unidirectional blood flow through the heart chambers. When valves become narrowed (stenosis), leaky (regurgitation), or fail to open and close effectively, they disrupt normal cardiac circulation and place excessive strain on the heart muscle.

VHD may be congenital (present at birth) or acquired later in life. Common acquired causes include age-related degenerative changes, rheumatic heart disease, ischemic heart disease, infections such as infective endocarditis, connective tissue disorders, and complications following heart attacks. In the UAE, aging populations and chronic conditions such as hypertension, diabetes, and coronary artery disease contribute significantly to valvular dysfunction.

The most commonly affected valves are the aortic and mitral valves.

• Aortic stenosis results from progressive calcification and narrowing of the aortic valve, leading to reduced blood flow from the heart to the body.
• Mitral regurgitation occurs when the mitral valve does not close properly, allowing blood to leak backward into the left atrium.

Other forms include mitral stenosis, aortic regurgitation, tricuspid valve disease, and multivalvular involvement.

Symptoms of VHD depend on the valve involved and severity of dysfunction. Early stages may be asymptomatic, but progressive disease commonly presents with shortness of breath, fatigue, reduced exercise tolerance, chest pain, palpitations, dizziness, syncope, or swelling of the legs and abdomen. Left untreated, significant valvular disease can lead to heart failure, arrhythmias, stroke, pulmonary hypertension, and sudden cardiac death.

Diagnosis requires comprehensive cardiac evaluation. Echocardiography is the cornerstone diagnostic tool, allowing detailed assessment of valve anatomy, severity of stenosis or regurgitation, chamber size, and ventricular function. Additional investigations may include ECG, chest X-ray, cardiac CT, cardiac MRI, stress testing, and in selected cases, cardiac catheterization to assess hemodynamic impact and coronary anatomy.

Management of VHD is individualized and based on valve type, severity, symptoms, ventricular function, and patient comorbidities. Mild disease may be managed conservatively with regular monitoring and medical therapy to control symptoms and associated conditions such as hypertension or heart failure. Moderate to severe disease often requires interventional or surgical correction, including valve repair or valve replacement using mechanical or bioprosthetic valves. Minimally invasive and catheter-based interventions are increasingly used in appropriate patients.