Patient-centered Treatment for Heart Valve Disease.

The heart’s chambers and valves work together to help pump oxygen-rich blood throughout the body. But for about 2.5% of people in the U.S., valvular heart disease can interrupt this balance and lead to symptoms that lower their quality and length of life. 

However, many people live with heart valve disease and do not experience symptoms. A recent U.K. study found that almost 30% of people over age 60 without symptoms or a history of cardiovascular disease had some form disease impacting their heart valves. In the U.S., more than 5 million people are diagnosed with heart valve disease each year. Our teams of experts can help.

Heart valve diseases tend to get worse over time. When symptoms do appear, they can include:

• Arrhythmia, or irregular heartbeat

• Chest pain during exercise

• Dizziness or fainting

• Fatigue

• Shortness of breath

• Swelling of the feet, ankles, belly, or the veins of the neck.

Heart valve disease can cause the valve to leak, narrow, or otherwise function poorly, making the heart work harder to pump blood. Left untreated, it can lead to blood clots, heart failure, sudden cardiac arrest, or death. 

Any of the heart’s four chambers can be affected by valvular heart disease. No matter which valve is causing trouble, the multidisciplinary teams at MedStar Health can identify the cause and create a treatment plan to give patients the best chance at a longer, healthier life.

How we diagnose valve disease.

The first step to helping patients find relief from symptoms is determine what’s causing them. To diagnose valvular heart disease, our experts use a number of methods, including imaging like chest x-ray, computerized tomography (CT) scan, echocardiogram, and/or magnetic resonance imaging (MRI).

We may also use an electrocardiogram (ECG) to measure the electrical activity in the heart, or a stress test to monitor how well your heart works during physical activity. To accurately measure the pressure inside the heart, cardiac catheterization is a minimally invasive process of guiding thin, flexible tubes through blood vessels. 

With these advanced tests, and often an old-fashioned stethoscope pressed against the chest, we can identify which heart valves are causing problems:

• Aortic valve disease: When the valve between the largest blood vessel (the aorta) and the heart’s main pumping chamber (the left ventricle) doesn’t work as it should. Complications can include abnormal heart rhythms, heart failure, and stroke.
• Mitral valve disease: The mitral valve controls the flow of blood between the left atrium and left ventricle. When it doesn’t open and close correctly, atrial fibrillation and heart failure can result.
• Pulmonary valve disease: The pulmonary valve controls the flow of blood as it passes from the heart and into the lungs. Pulmonary valve disease includes conditions that decrease the supply of oxygen to the body.
• Tricuspid valve disease: The tricuspid valve manages blood flow between the heart’s upper right (atrium) and lower right (ventricle) chambers. Narrowing (stenosis) and leaking due to improper closure (regurgitation) are common forms of tricuspid valve disease.

Once we identify the source, we gather our team of experts to discuss the best strategy for effective treatment.

Team-based decision making improves care.

At MedStar Health, we work together to make sure our patients have the best outcomes. When it comes to heart valve disease, that means weekly meetings between cardiologists, cardiovascular imaging specialists, interventional cardiologists, and cardiac surgeons like me.

During these meetings, we discuss in detail our patients’ imaging and other test results. We talk about their goals for life after treatment, and any other health conditions that might impact our decisions. 

With each patient’s goals in mind, we develop a treatment plan together that can help resolve their symptoms and provide a chance at a longer and healthier life.

Related reading: Valve Disease Treatment: A Team Approach Is a Winning Strategy.

Treatment of heart valve disease.

Our teams have been at the forefront of minimally invasive treatment for heart valve disease since day one, and patients travel from around the country to get surgery from our experienced experts. But the most advanced treatments aren’t always right for everyone, and often the best care begins long before surgery.

For patients with mild disease, regular testing to monitor function and medications to control blood pressure and heart rhythm can help. Changes in lifestyle can make a difference, too, so we often recommend patients reduce their salt intake, drink less alcohol, and keep up with exercise.

When heart valve disease is more advanced, traditional and minimally invasive surgical options can minimize complications and improve symptoms. The main types of surgery include:

• Valve repair: By reshaping tissue or inserting supporting rings, surgeons can improve valve function. 

• Valve replacement: When valves are damaged beyond repair, natural body or synthetic tissue can be used as a replacement.

While there are several innovative surgical treatments that can help, the one patients ask about most is transcatheter aortic valve replacement (TAVR). MedStar Health experts have been involved in every major clinical trial of this groundbreaking, minimally invasive treatment to replace the aortic valve. Our surgeons performed more than about 550 of these procedures last year.

For many patients, TAVR is an excellent procedure that produces great outcomes. But for others, including those who are older, whose disease is advanced, or who have other conditions, traditional surgery can be a better choice. 

Prevention: Work with your primary care doctor.

When it comes to keeping a healthy heart, most of us know what we should do:

• Choose foods that are lower in fat, less processed, and with less high fructose corn syrup
• Don’t smoke—and if you do, quit. We can help.

• Drink alcohol in moderation

• Exercise in moderation

Remember that a bit of prevention goes along way, especially when you develop heart healthy habits while you’re young. Talk with your primary care provider if you experience symptoms of heart valve disease. Your doctor, physician assistant, or nurse practitioner can help you navigate the care system, determine your next best steps, and provide you with verified information you can use to make good decisions.