Heart Valve Disease: Diagnosis and Treatment

Irving Herling, MD
Director, Clinical Cardiology
Main Line Health

Nearly 5 million people are diagnosed with heart valve disease each year, according to the American Heart Association.  People do not always show symptoms, but your doctor may detect valve disease during your annual physical.

The first signs of heart valve disease are often found when your doctor listens to your heart and hears a distinctive sound indicative of the condition. To better evaluate the cause and severity of that finding, he or she may request an echocardiogram which uses sound waves to show your valves opening and closing, and the impact of those valves on blood flowing through your heart.

Once your diagnosis is made, your doctor may request further testing, including:

• an electrocardiogram (ECG), a painless test where electrodes are attached to the skin to measure the electrical activity of the heart
• a stress test, a treadmill test that monitors a patient’s heartbeat, breathing rate, blood pressure and ECG changes while exercising
• cardiac catheterization, an invasive procedure where a catheter is threaded into the heart chambers to detect valve issues

There are two main types of valve problems. Valves can be stenotic – too narrowed or hardened to open fully, or incompetent or leaky – too loose to close completely. Both concerns disrupt the one-way flow of blood through the heart.

Many people with heart valve disease require no treatment, other than regular monitoring to make sure the condition does not worsen. If your condition does require treatment, your doctor may recommend:

• antithrombotic medicines, like aspirin, to prevent blood clots
• valve surgery to repair or replace a damaged valve – the mitral valve is the most commonly repaired valve, while aortic and pulmonic valves generally require replacement
• Medications to forestall the need for replacing or repairing your valve

If you or a loved one has been diagnosed with aortic stenosis, usually a condition associated with aging, the only course of treatment used to be open heart surgery to replace the aortic valve. Now, a procedure called Transcatheter Aortic Valve Replacement (TAVR) may be an option. With TAVR, the valve is replaced via a catheter and is much less risky.

Join Dr. Herling live at Lankenau’s  Web Chat, tonight at 7 p.m.: Living With Heart Valve Disease: Your Own & Your Loved One’s. This web chat will also feature a patient who has recently recovered from mitral valve repair surgery. Sign up now.

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