Valvular heart disease
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Valvular heart disease is any disease process involving one or more valves of the heart. The valves in the right side of the heart are the tricuspid valve and the pulmonic valve. The valves in the left side of the heart are the mitral valve and the aortic valve.
In March 29, 2007, pergolide, a dopamine agonist used in treatment of Parkinson's disease and also off label for Restless legs syndrome (RLS), was withdrawn from the US market due to implication in valvular heart disease [2]. The withdrawal was based on findings published in New England Journal of Medicine, confirming previous reports associating pergolide with increased risk of regurgitation of the mitral valve, tricuspid valve, and aortic valve of the heart. Cabergoline, a similar ergot-derived dopamine agonist, is still marketed in EU.
Ergot derivatives (ergotamines) have been implicated in fibrosis not only of the heart valves but also of the pleura and retroperitoneum [3] and possibly other locations.
Types
Each valve may be too narrow (stenosis) or too wide or loose, causing regurgitation. There are different types of valvular heart disease:
- Aortic insufficiency
- Aortic valve stenosis
- Endocarditis
- Libman-Sacks endocarditis
- Loeffler endocarditis
- Mitral regurgitation
- Mitral stenosis
- Mitral valve prolapse
- Pulmonary valve stenosis
- Pulmonic regurgitation
- Tricuspid insufficiency
- Tricuspid valve stenosis