What is the difference between congenital and acquired valvular heart disease?

Congenital valve disease is when a valve is malformed at birth (e.g., a bicuspid aortic valve). Acquired disease develops later due to infection, inflammation, degeneration, or structural stress.

Is rheumatic heart disease still a significant cause in modern times?

Yes, in many low and middle-income countries, rheumatic heart disease remains the leading cause of noteworthy valvular defects in young people. It is less common in high‐income countries due to better access to treatment for streptococcal infections.

At what age does degenerative valve disease usually appear?

Degenerative changes generally become clinically significant in older adults, often after age 65-70 for aortic stenosis, somewhat earlier if there is congenital vulnerability.

Why do patients with congenital bicuspid aortic valves develop aortic stenosis earlier?

Because the abnormal valve geometry causes greater mechanical stress and turbulent flow, which accelerates calcification, fibrosis, and wear, the leaflets may also be structurally less robust.

Can valvular heart disease be prevented?

In many cases, yes: treating streptococcal infections early to prevent rheumatic fever; reducing risk factors for calcific degeneration (managing hypertension, lipids, and kidney disease); preventing and managing infective endocarditis (through dental hygiene and prophylaxis in high-risk patients); and early detection and monitoring of congenital valve anomalies.

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Understanding the Causes of Valvular Heart Disease: From Birth Defects to Ageing

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