Heart Valve Issues and Hypertension: Risks and Treatments

Heart disease & hypertension

Hello, Dr.
Ko.
My boyfriend has been experiencing chest tightness due to stress for quite some time, to the point where he couldn't sleep.
After much persuasion, he finally went to the hospital for an examination.
He said the doctor informed him that he has heart valve insufficiency (which I cannot confirm) and that this has caused his systolic blood pressure to reach 180 and diastolic pressure to be 130.
The doctor mentioned that he is at risk of sudden cardiac death unless he undergoes heart surgery.
Could you please tell me if such symptoms really exist in medicine? What is the likelihood of recovery after surgery? My boyfriend doesn't seem to care much about it and doesn't want his family to know, so I would appreciate any advice you can provide.
Thank you!

Xiao Yu, 20~29 year old female. Ask Date: 2001/05/27

Dr. Ke Zhengchang reply Internal Medicine

If a young male has a blood pressure of 180/130, he must seek emergency treatment for malignant hypertension and be hospitalized for further evaluation to determine the cause of the hypertension.
Unless there are severe congenital anomalies or abnormalities of the heart and major blood vessels, cardiac surgery is not necessary.
It is important to visit a cardiology outpatient clinic for examination and treatment.
Additionally, regularly monitoring blood pressure and adopting a low-sodium, low-fat diet along with maintaining a normal daily routine are also crucial.

Reply Date: 2001/05/27

More Info

Understanding heart valve issues and hypertension is crucial, especially when it comes to the potential risks and treatment options available. Your boyfriend's situation, characterized by severe hypertension and suspected heart valve insufficiency, raises significant concerns that warrant immediate attention.

Heart Valve Insufficiency and Hypertension
Heart valve insufficiency, also known as valve regurgitation, occurs when one or more of the heart's valves do not close properly, allowing blood to flow backward instead of forward through the heart. This condition can lead to various symptoms, including chest pain, shortness of breath, and fatigue. In your boyfriend's case, the chest pain and difficulty sleeping could be attributed to the stress placed on the heart due to the malfunctioning valve.

Hypertension, particularly when it reaches levels like 180/130 mmHg, is a serious condition that can lead to life-threatening complications, including heart failure, stroke, and even sudden cardiac death. The combination of severe hypertension and heart valve issues can exacerbate the strain on the heart, increasing the risk of acute cardiovascular events.

Risks Associated with Heart Valve Issues and Hypertension
The risks associated with untreated heart valve insufficiency and hypertension are significant. The heart may become enlarged (a condition known as cardiomyopathy) as it works harder to pump blood effectively. This can lead to heart failure, where the heart is unable to pump enough blood to meet the body's needs. Additionally, the high blood pressure can cause damage to the arteries, increasing the risk of atherosclerosis (hardening of the arteries) and other cardiovascular diseases.

Treatment Options
1. Medication Management: Initially, doctors often manage hypertension with medications such as ACE inhibitors, beta-blockers, diuretics, or calcium channel blockers. These medications can help lower blood pressure and reduce the workload on the heart.

2. Surgical Interventions: If the valve insufficiency is severe and causing significant symptoms or complications, surgical intervention may be necessary. Options include:
- Valve Repair: In some cases, the existing valve can be repaired to restore proper function.

- Valve Replacement: If repair is not feasible, the damaged valve may need to be replaced with a mechanical or biological valve. The success rate for these surgeries is generally high, with many patients experiencing significant improvements in symptoms and quality of life post-surgery.

3. Lifestyle Modifications: Alongside medical treatment, lifestyle changes are crucial. This includes adopting a heart-healthy diet, engaging in regular physical activity (as tolerated), managing stress, and avoiding smoking and excessive alcohol consumption.

Prognosis and Recovery
The prognosis for individuals with heart valve insufficiency and hypertension largely depends on the severity of the conditions and the timeliness of treatment. If your boyfriend is diagnosed and treated early, particularly if he adheres to medication and lifestyle changes, the outlook can be quite positive. Surgical interventions, when necessary, also have a high success rate, with many patients returning to normal or near-normal activities post-recovery.

Conclusion
It is essential for your boyfriend to take his symptoms seriously and seek medical attention. Encourage him to discuss his condition openly with his healthcare provider, as this will help him understand the risks and the importance of treatment. If he is hesitant to involve family, perhaps suggesting a consultation with a cardiologist could help him feel more at ease about his situation. Early intervention can make a significant difference in outcomes, and it is crucial to address both the valve insufficiency and hypertension to prevent further complications.

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