Valvular Heart Disease Mechanisms

Valvular disease is a flow problem with two broad consequences: obstruction raises the pressure required to move blood forward, while leakage sends blood backward and increases the volume the receiving chamber must handle. The chamber that bears the burden remodels, but compensation has limits. Use the A-to-D framework to place the patient: stage A means at risk, stage B progressive disease, stage C asymptomatic severe disease, and stage D symptomatic severe disease. Stage is not assigned from a murmur or one echocardiographic measurement alone. Symptoms, valve anatomy, haemodynamic severity, ventricular size and function, pulmonary pressures, and rhythm changes determine how urgently the patient needs specialist assessment.