National Heart Valve Disease Awareness Day
Identifying “the mystery killer”
February 22nd marks the third annual National Heart Valve Disease Awareness Day. As many as 11 million Americans have heart valve disease (HVD) — a potentially disabling and deadly disease. It’s known as the mystery killer and for good reason. Most patients mistake symptoms like fatigue or shortness of breath as exhaustion. According to a recent national survey, 3 out of 4 Americans know little to nothing about HVD. This year, Capital Cardiology Associates is proud to join the movement to raise awareness about heart valve disease and protect patient lives.
The big problem
More than 1 in 10 adults ages 75 and older have HVD. One of the awareness challenges with valve disease is that it’s a problem much bigger than one description. Dr. Donna Phelan has a special area of interest in echocardiography and non-invasive cardiology. She explained the different types and severities of valve disease. “HVD is a very general, broad term that encompasses any problems relating the four valves of the heart.” The heart has four valves, separating the various chambers of the heart, allowing it to pump blood. “When a person develops HVD, any of the four valves or multiple valves may be involved in the condition, and the valves are a lot like doors, they are supposed to open when they need to, to let the blood flow, they are supposed to close to keep the blood in the location needed.”
A heart with valve disease can experience stenosis when the valve becomes narrow. A narrowed or “stenotic” valve requires the heart to pump harder, which can strain the heart and reduce blood flow to the body. Another condition, called valvular insufficiency (or regurgitation, incompetence, “leaky valve”), takes place when the leaflets of the heart do not close properly, allowing blood to leak backward through the valve. This condition causes the heart to work harder to pump blood through the body. “Or they can become thickened or calcified and not open as well as they should, restricting the blood flowing through them,” pointed out Dr. Phelan.
Identifying valve disease
Typically in the early stages of most types of HVD people may not have any symptoms. “The first step in identifying a person with heart valve disease is asking questions, building their family history, and obtaining their risk of developing heart valve disease,” stated Dr. Phelan. Patients with high blood pressure, high cholesterol, and diabetes have an increased risk of heart valve disease. Common causes of valve disease include rheumatic fever, birth defects, degeneration over time and infection. “The second step is putting your stethoscope on their chest and listening for the murmurs that are often associated with valve disease. Then we move on to EKG’s, echocardiograms, and stress tests, which all to help us diagnose the type of valve disease and what needs to be done next.”
Living with heart valve disease
The good news: recovery statistics are encouraging for people who receive proper treatment. “Most often HVD is something people can live with for decades,” said Dr. Phelan. There are also multiple treatment options due depending on the severity of the disease stage. “Often, in the early diagnosis there is an observational period, there may not be a need for treatment. At certain levels of HVD, there are certain levels of treatment that we use medication, including adjusting blood pressure medications that help to reduce the effect of the strain of the blood pressure and the pumping functions of the heart on those valves, providing the time for the valves to rest for lack of a better way of describing it.”
In some cases, open-heart or minimally invasive surgery will be necessary to repair, restore, or replace the heart valves. Your doctor will discuss with you whether heart valve repair or replacement is most appropriate for your condition. Most often, physicians recommend repair when possible as that option preserves the valve and heart function. At Capital Cardiology, our Valvular Clinic performs the TAVR procedure, a minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. This procedure is reserved for patients in their 70’s or 80’s and often have other medical conditions, for whom an open heart procedure poses an intermediate risk.
Lifestyle changes will also be a significant part of your treatment. Expect your doctor to advise modifications in physical activity, a healthy diet, stress management and avoiding tobacco use. You will also have regular visits with your cardiologist. “Follow-up appointments help keep tabs on the condition or valve problem before it gets too late or is not treatable any longer,” noted Dr. Phelan. Her biggest advice for patients with heart valve disease or those looking to reduce their risk of developing a condition, “keep an eye on your blood pressure.”