Heart Valve Disease: Listen to Your Heart

As many as 11 million Americans have heart valve disease (HVD) and approximately 25,000 people die from the disorder each year, yet three out of four of us report knowing little to nothing about HVD. The good news: February 22nd has been designated an annual (and much-needed) National Heart Valve Disease Awareness Day. Here, Stony Brook Valve Center Cardiologist, Ahmad Alkhalil, MD, helps to fill in some of the HVD blanks.

What is Heart Valve Disease (HVD)?
Your heart has four valves — the aortic, mitral, tricuspid and pulmonary — and their job is to keep your blood flowing in the right direction. If you have HVD, the flaps (leaflets) of one or more of the valves do not open and close properly, causing the flow of blood to be disrupted. Two of the most common heart valve problems are mitral regurgitation (leaking), in which a flap does not close completely and, aortic stenosis, in which a narrowed valve causes a reduction in blood flow. In each case, a damaged valve means the heart has to work harder and, if left untreated, can lead to such serious complications as blood clots, stroke and heart failure.

Who’s at Risk for HVD?
Key valve disease risk factors are high blood pressure and high cholesterol, diabetes, a previous heart attack, heart failure, infection or congenital (present at birth) heart condition and advanced age — one in eight people aged 75 and older are thought to have moderate to severe heart valve disease.

What Are the Symptoms?
HVD symptoms are similar to those of other heart diseases: chest pain, irregular heartbeat (palpitations), fatigue, dizziness and shortness of breath. But these symptoms often go undetected or dismissed — or, there may be no symptoms at all — never causing any significant valve problems for some people and, for others, allowing the disease to advance and worsen.

How is HVD Diagnosed?
Valve disease may be detected when a routine physical exam reveals a heart murmur (abnormal ‘whooshing’ sound), but it is possible, also, to have a murmur unrelated to valve trouble. Comprehensive diagnostic testing to define, evaluate and confirm potential heart valve damage includes 2D and 3D transthoracic and transesophageal echocardiograms, stress echocardiograms, cardiac MRI, CT (computer tomography) scan, nuclear and carotid ultrasound imaging and pulmonary function tests.

How is HVD Treated?
While Stony Brook offers a full range of treatment and prevention options — including medical management and monitoring, diet and lifestyle modification, and genetic counseling — it is often necessary to repair or replace a diseased valve or valves. Our cardiac care specialists work closely with you and your referring physician to find just the right treatment program to provide you with the best outcomes and best experience. Heart valve repair and replacement procedures include traditional open-heart surgery and these minimally invasive techniques:
• Transcatheter Aortic Valve Replacement (TAVR) to open up a valve that has been narrowed by aortic stenosis.
• Transcatheter Mitral Valve Repair (TMVR) to restore a malfunctioning valve flap and shut down any blood flow leakage.
• Additional Minimally Invasive Options. We also offer transcatheter mitral valve replacement, percutaneous valve repair and complete care for bicuspid aortic valve disease.

What Can Be Done Today?
Early detection and timely treatment of heart valve disease is so important for optimal outcomes. Everyone should have their heart listened to by a healthcare provider regularly because valve disease can often be detected with a simple stethoscope check. Heart Valve Disease Awareness Day is a good reminder to take action and make that appointment today with your healthcare professional to get your heart listened to.