Is your fatigue and shortness of breath simply a sign you are getting older or do these symptoms indicate valvular heart disease? If left untreated, this disease may lead to ongoing damage to the heart, including congestive heart failure. Your quality of life and longevity depend on treating valvular heart disease.

The heart is an amazing structure that acts as a powerhouse for the body. It has four chambers and each chamber has an outlet called a valve. Healthy valves allow one-way flow through each of the four heart chambers, serving as a doorway between two chambers (see figure).

 

What Causes Valvular Heart Disease?

Heart valves are prone to wear and tear with age. The prevalence of valvular heart disease in octogenarians approaches 10 percent.  In addition to aging, valve damage may also be attributed to birth defects, infection, calcium buildup, radiation therapy, rheumatic fever, or even trauma in rare cases.

Valvular heart disease hinders the pump function of the heart. Turbulence through the malfunctioning valve routinely causes a discernable murmur upon examination. In the adult population, left-sided valvular heart disease is more common, in particular the aortic and the mitral valves. Damage occurs progressively as the valve becomes less flexible and irregularly formed. A damaged valve may not completely open and/or close, which may lead to leakiness (regurgitation), narrowing (stenosis), or both. A heart muscle weakened by regurgitation and/or stenosis often causes easy-to-ignore symptoms such as fatigue and shortness of breath. The disease may also lead to chest pain, dizziness or passing out.

Patients presenting with symptoms of valvular heart disease require a thorough diagnostic workup. Your doctor will perform an ultrasound of the heart by using a probe on the chest (transthoracic echocardiogram) or by inserting a probe in the esophagus (transesophageal echocardiogram). Other diagnostic procedures include cardiac catheterization/angiography to measure pressures in the heart and lungs and to exclude plugging of the heart arteries. A lung function test and frailty assessment may be performed prior to corrective surgery for more severe cases.

 

What are the Treatment Options?

All treatment options with The Heart Group feature a team approach that emphasizes patient-centric care and shared decision-making. The heart team generally comprises cardiologists, cardiothoracic surgeons, anesthesiologists, and nurse coordinators. This team discusses treatment options with the patient, which include medications and various procedures to replace or repair the damaged valve. In the past, open-heart surgery to replace the damage valve was the only option, but today less invasive therapies are providing quality outcomes with less surgical trauma and faster recovery. Rather than removing and replacing the diseased valve with invasive open-heart surgery, these therapies do not require removing the diseased valve in order to repair it.

We are in an era of exciting technological advancement with various transcatheter options such as transcatheter aortic valve replacement (TAVR), transcatheter pulmonary valve replacement (TPVR), and transcatheter mitral valve repair (M-TEER).  Additionally, numerous trials are underway for transcatheter mitral valve replacement (TMVR) and transcatheter tricuspid valve repair (T-TEER). In each case, a flexible tube carrying a new valve (or a clip) is inserted into a small incision in the groin and guided through the artery into the area of the diseased valve. Once positioned, the new valve is expanded into place, restoring proper function to the diseased valve without removing it. The Heart Group regularly performs transcatheter procedures with excellent outcomes for our patients.

If you are experiencing any of the aforementioned symptoms, it is important to see your doctor for further evaluation. With proper diagnosis and treatment, valvular heart disease does not have to affect your quality of life. While we cannot stop your body from aging, we can reduce or eliminate the fatigue and shortness of breath you may have considered inevitable. And with today’s technological advancements, we can treat valvular heart disease with less invasive procedures and quicker recovery times. Why put off treating valvular heart disease? Especially now.

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Dr. Usman Javed is an interventional cardiologist who is board certified in internal medicine, cardiovascular disease, interventional cardiology, and vascular/endovascular medicine. Dr Javed is a registered physician in vascular interpretation, certifying the highest standard in vascular ultrasound interpretation. He holds staff privileges at Saint Agnes Medical Center, Clovis Community Hospital, Fresno Heart Hospital, and Fresno Surgical Hospital. To learn more about conditions of the heart, please visit theheartgroupfresno.com