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Series Code: UP
Program Code: UP000062A
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00:16 They've been called "sticky, leaky,"
00:19 and even in need of replacement. 00:22 Today we talk about "heart valves," 00:24 and how, when they stop functioning, 00:26 so do we, stay tuned... 00:30 I'm Dr. James Marcum, are you interested in 00:33 discovering the reason why? 00:35 Do you want solutions to your health care problem? 00:38 Are you tired of taking medications? 00:41 Well, you're about to be given "The Ultimate Prescription" 00:45 "Mitral valve prolapse," I hope you never have to 00:51 hear those words coming from the lips of your doctor. 00:54 To make sure you don't, you might want to pay close 00:57 attention to the words coming from the lips of 00:59 our doctor today. 01:01 Dr. James Marcum is a board certified cardiologist, 01:04 and someone who has dedicated 01:05 his life to going out of business. 01:07 Dr. Marcum, what do we need to know? 01:10 Well Charles, that was quite a dramatic introduction, 01:13 and mitral valve prolapse is usually not that dangerous. 01:18 And with mitral valve prolapse, 01:19 we're going to talk about valves. 01:21 Valves help direct the flow of blood throughout our body. 01:25 Of course, we have very important valves in our heart, 01:28 and three of them are very, very important; 01:30 the mitral valve - we talked about that; 01:33 the aortic valve, the tricuspid valve, 01:36 but we have valves throughout other parts of our body. 01:38 Did you know that our veins have valves that help 01:41 push the blood up to the heart... 01:43 And that's very important to know because when those 01:45 valves are damaged and you 01:46 retain lots of fluid in your legs, 01:48 you have a higher chance of having blood clots... 01:51 And blood clots that get in the legs and pumped up 01:53 that's why I want to tell everyone to keep those valves 01:55 happy and move those legs every hour, 01:58 and get out of a position that you have been staying in. 02:00 That could actually save your life. Absolutely! Yeah 02:02 But mitral valve prolapse is a condition of the valve 02:06 where you are born this way usually, 02:07 and the valve, instead of closing here, 02:10 it closes there and sometimes when it doesn't close good, 02:14 it does leak blood backwards. 02:16 And leaking of blood backwards is part of the problem 02:19 of the valve disease. 02:20 If you leak a lot backwards, 02:22 and the heart needs blood to pump forward, 02:24 and more of it is going backwards than forwards, 02:27 you get a symptom... 02:29 And some common symptoms of valvular heart disease 02:32 are shortness of breath when you do things. 02:35 Of course, if blood can't get out of the heart 02:38 because the aortic valve doesn't open up, 02:40 a symptom might be passing out because you don't have 02:43 enough blood going to your head; 02:44 chest pain and, of course, shortness of breath as well. 02:49 So valvular disease is very important; 02:51 sometimes we're born with it, like mitral valve prolapse, 02:54 and sometimes we get it through the 02:56 process of just getting older. 02:58 Sometimes we get valvular disease from an infection. 03:00 I don't know if you've heard of "rheumatic heart disease," 03:03 but that's an infection. 03:04 We don't see much of that anymore since 03:06 the invention of antibiotics. 03:08 Sometimes a valve will have problems with hearts. 03:13 You know, heart valves for instance are very common 03:16 that they have blockages in the arteries of the heart, 03:18 the arteries feed the valve in what it needs to do to move. 03:20 So sometimes if you have a heart attack, 03:22 the valve malfunctions as well 03:23 depending if their blood supply is disrupted. 03:26 Those are some of the more common causes. 03:29 Sometimes blood pressure, for instance, being high 03:31 year after year can stretch things out 03:33 and then the valve itself is structurally okay, 03:35 but because the heart has been stretched out from all 03:37 that pressure, the valve leaks so the valves either don't 03:41 open, they leak or they're damaged usually from an 03:45 infection or some other issue. 03:47 So those are the things we're going to talk about today, 03:49 and lots of questions have come in regarding valve disease 03:53 so let's see if we can answer a few of those. 03:55 These are questions that have been sent in to the 03:57 heartwiseministries.org website, 03:59 and we invite you to do that listener and watcher 04:01 if you would like to be a part of this program, 04:03 we invite you to do that. 04:04 Just send your questions to heartwiseministries.org 04:07 and here's one... "I have been diagnosed, 04:09 the writer said, with mitral valve prolapse... 04:13 What should I be concerned about? 04:15 My doctor doesn't seem to be concerned." 04:17 Well you just described some pretty 04:18 dire problems that that can bring about. 04:20 Why isn't the doctor concerned? 04:22 Well first of all, mitral valve prolapse, most of the time, 04:25 is not a major issue. 04:26 If the valve closes here and it doesn't leak a lot, 04:29 that's not a big deal. Okay 04:30 It's only a big deal when the valve leaks a lot. 04:33 And this is a heart that we have here and we'll show 04:38 this heart here and the mitral valve is right over here. 04:41 If the blood leaks back into this chamber which is called 04:44 "the atrium," you can get short of breath, 04:47 and that can be a big problem, 04:48 especially when you're exercising. Yes 04:50 So if a person with mitral valve prolapse has shortness 04:53 of breath when they do things, a real leaky heart valve 04:56 we're lucky that we can actually repair that valve. 05:00 You go into the heart and repair it. Yeah 05:01 We can repair that valve. 05:03 Now, the way we would tell if a person had 05:06 mitral valve prolapse and it was any significance 05:09 would be a sound wave test, an ultrasound 05:11 where we can look at that valve, see how it's closing, 05:14 and see how much it's leaking. 05:16 Another way we could do it, it's sort of an inexpensive way 05:19 is I can listen to the heart and I could hear the blood 05:21 going backwards... we call that a "murmur." 05:24 You could hear it going back? What does it sound like? 05:26 It's a whooshing sound. A whooshing sound. 05:28 You can hear that with the stethoscope, 05:30 the blood going backwards. 05:32 What does forward sound like? 05:34 You don't hear anything when it moves forward. 05:35 You might hear the valves opening and closing, 05:37 those are the heart sounds. 05:39 You know... bump, ka-domp, pa-domp... 05:41 That's what we hear when we listen to the heart. 05:42 That's actually the aortic and mitral valve 05:44 opening and closing. Oh okay 05:46 So that's what we hear when we 05:47 listen to the heart and the valves. 05:48 So if we hear the blood going backwards 05:50 or a turbulent flow, we can say, 05:51 "Wow, there might be something wrong with the valves." Yes 05:56 And I'd say, "Well, if I hear something suspicious"... 05:58 And I said, "Well, can you walk 6 minutes 06:00 pretty well without having problems?" 06:02 "Oh yeah, I do that without problems, I exercise every day." 06:04 Well then I can learn that the chances are that 06:07 that murmur is probably not significant. Okay 06:10 If I'm concerned about it, I can do a test called an 06:13 "ultrasound" which uses sound waves to generate 06:16 the picture of the heart and the valve and I can actually 06:18 see the blood flowing backwards and there's different 06:21 measurements that we do to see if it's very significant. 06:24 So mitral valve prolapse, not that many people go on 06:27 to have significance, but if they do, 06:28 they get short of breath when they do things, 06:30 we can pick it up with the sound wave test, 06:32 and thank goodness, we can repair that valve 06:34 so they don't have to have problems, 06:36 and I probably do 4 or 5 over a 10 year period 06:39 for the mitral valve that gets worse. 06:41 Now here's a writer to heartwiseministries.org 06:44 that says, "My aorta valve does not open well." 06:47 Where's the "aorta valve?" 06:49 Let's use this big one, this is a big heart. 06:51 I think it has a bigger picture of the aorta. All right 06:54 Well, you know, they don't let us bring real hearts 06:56 on the program, Charles, because we have to 06:57 put them in formaldehyde. 06:59 This is a hard-hearted person. 07:00 Yes, this is a plastic-hearted person. Thank you 07:03 Well anyway, this is the valve, the aortic valve that 07:06 leaves the heart and it goes out the aorta. Okay 07:09 Okay, this is the aortic valve right here, 07:10 and what was the question there? 07:12 It says here, "My aorta valve does not open well. 07:15 My doctor says I may need surgery someday. 07:17 How will I know if my valve is worsening?" 07:19 Right, so if this valve does not open, 07:22 the blood can't leave the heart very well. Okay 07:25 And if the blood doesn't leave the heart, pressure builds up 07:27 inside and the muscle has to squeeze 07:29 harder to get the blood out. Gotcha 07:31 So it takes extra pressure to get the valve open. Yeah 07:35 And there are different things that can cause aortic stenosis. 07:39 And one of the things it can cause is just getting older. 07:41 You know, the valves get older. 07:43 I wish you would not keep saying that because I'm getting older. 07:47 Does that mean I'm going to have to watch for 07:49 these things just because I'm getting older? 07:50 Well, you might wear out, but a lot of people 07:52 don't have valve problems, but it gets calcium 07:55 on the valve, so it takes more pressure to open the valve. 07:57 Other people are born - usually you have 3 leaflets 08:00 to the aortic valve - some people are only born with 2. 08:04 We call that a bicuspid aortic valve, 08:06 and because there's not as much cusp to take the pressure, 08:11 it puts more pressure on the 2 cusps that are worse, 08:15 and that tends to wear them out sooner. 08:16 So frequently gentlemen with bicuspid valves, 08:19 or females with bicuspid valves have those replaced as well. 08:23 But the question is, "Well how might I feel?" 08:25 Well a person that might feel that way, might have 08:27 shortness of breath; 08:29 they might get dizzy and pass out. 08:30 The way we tell is, you get a routine physical 08:33 and your doctor listens and boy, I hear a murmur. 08:36 If I hear a murmur of that squishing sound, 08:38 depending on the characteristics of that murmur, 08:40 I can tell just by listening and just by talking to the patient, 08:44 whether it's real serious. 08:45 But to keep an eye on it, we do a sound wave test again, 08:49 and some specific things... we'd look at the valve 08:51 and see if it's opening like this or just opening like that. 08:54 And then we can also measure 08:55 the pressure that opens the valve. 08:58 Normally, we want less than 10 mmHg 09:01 to open that valve fully, but when the pressure 09:03 that the heart has to generate reaches 50, 09:06 that's a sign to me - that that valve needs a lot of 09:09 pressure to open it to get blood throughout the body. 09:11 The heart has to work hard, that's a sign for me that 09:14 maybe it's about time to replace the valve, 09:16 and we can replace the valve in many different ways... 09:20 We can put in a metal valve; 09:22 we can put in a cow valve; a pig valve. 09:24 You would hear that metal valve, 09:25 would there be a clicking sound then? 09:26 Yes, you would hear the clicking sound if it was metal. 09:29 We can put in cow valves, we can put in pig valves. 09:31 Sometimes depending on the age of the person... 09:34 Unfortunately when we put in metal valves, 09:36 they generate blood clots, so we have to put patients on 09:38 blood clot...prevention... after it, but the metal valves, 09:41 the stainless steel valves, the most common one I use 09:43 is the St. Jude's valve, they last forever. Okay 09:46 But the problem is, you have to take blood thinners. 09:48 The problems with the pig and cow valves... 09:50 they don't last as long. 09:52 But there's now these bioprosthetic valves 09:54 that they're now putting in. 09:55 Some of them have some real excellent lifespans as well. 09:58 So this person - "My doctor says, "He probably has a 10:01 bicuspid valve - the valve doesn't open well." 10:04 So your doctor will tell if it's getting worse 10:07 by listening to it, by talking to you, 10:09 and periodically maybe even ordering an ultrasound 10:11 which is called an "echocardiogram," 10:13 that will tell you if the valve is worsening. 10:15 That is a great question! 10:17 Yeah, okay, now the next question here... 10:18 "Can high blood pressure cause a valve to leak?" 10:22 We know that the pressure goes up if there's a leaky valve, 10:25 and a bad valve, but can having high blood pressure 10:28 throughout your body cause a valve problem? Yes, yes 10:30 And what can happen... For instance, the pressure 10:33 high everywhere, it makes things dilate. 10:35 You know, think of a door... The door got bigger, 10:39 the doorjamb is not going to close completely. Right, right 10:42 So if the valve is normal here, if the vessel that the valve 10:45 is attached to has pressure on it and it gets bigger, 10:49 the valve doesn't close as well, 10:51 and even though the valve is completely normal, 10:53 because the door is not closing completely, 10:57 the blood can leak backward... 10:58 And that happens very often especially in conditions 11:02 like we call it "aortic insufficiency." 11:04 The aortic valve doesn't close well, 11:06 so it's "aortic insufficiency." 11:08 When it doesn't open well, we call that "aortic stenosis." 11:12 The next question was, "Can this high blood pressure 11:14 cause a valve to break?" 11:16 Can it actually just stop it from functioning completely? 11:19 No, remember if the blood vessel gets bigger, 11:23 the valve ends don't meet and that's when it leaks. 11:27 And if it leaks a whole lot, then the solution is that 11:31 we can do some things that help a lot, 11:33 but the valve itself is usually structurally normal. 11:36 So, I'm going to digress here, in the heart we usually have 11:39 2 valves that we're really concerned about; 11:41 that's the aortic valve which leaves the heart, 11:47 and the mitral valve - this is the valve that when the 11:50 blood is oxygenated, it comes into the left ventricle... 11:53 This valve sometimes leaks, 11:55 that's the one we call "mitral valve prolapse." 11:57 There's another valve on this side of the heart called the 11:59 "tricuspid valve," but that one, you can actually live without. 12:04 So you can live without that valve. 12:06 So but what we can do is all sorts of things to help 12:08 this valve and that valve and there are some things 12:10 like the blood pressure that we said that can take care of it. 12:13 But this, Charles, is a 12:14 Do you transplant that valve over to there? 12:15 Well, there is a procedure where we move the 12:18 pulmonic valve into the aortic position... 12:22 That's called a "Ross procedure." 12:24 We don't do that that much. 12:26 It had some problems with it, so most patients nowadays 12:29 either get a metallic valve or they get what we call a 12:33 "bioprosthetic valve" from someone else 12:34 and they put that one in. 12:36 But valve disease is a great place for modern medicine. 12:40 Years ago, if you had an infection 12:41 that ate through a heart valve, you would die. 12:45 If you were old and had a valve that 12:46 wouldn't open, you would pass away. 12:48 But this is a great place for modern medicine 12:50 to help prolong life so we can continue serving God. 12:53 So lots of people have valve disease and it comes from 12:56 getting older; it comes from having a 12:58 heart that's damaged; maybe high blood pressure; 13:00 maybe infections, but we have some great treatments now 13:03 for valvular heart disease. 13:05 And I would assume, Dr. Marcum, that what we do for heart 13:08 health - the diet, the exercise and all those things, 13:11 are also good for the valves. 13:13 Yes, it's all good for the valves and there are some 13:14 people who think eating the wrong types of foods 13:17 cause oxidation and oxidation sort of triggers 13:21 calcium to stick on the valves, 13:22 so there's that part out there. All right very good... 13:24 Well, we have a lot of questions here, 13:26 and, again, I want to invite our viewers to send their 13:28 questions in to: heartwiseministries.org 13:30 We use these questions to decide what to say on our program. 13:34 We structure our program around your questions 13:36 many times and if you would like to be part of this program, 13:38 just go to the heartwiseministries.org website 13:41 and leave your question there. 13:42 We will be happy to address it on a program. 13:45 We'll take a short break and when we come back, 13:47 we're going to take a moment and we're going to look at 13:49 God's prescription book, the Bible, 13:51 to find a text that might be just exactly what you're 13:54 needing, right now, to build your health. 13:56 So stay right where you are... |
Revised 2016-03-01