What Does a Heart Valve Disease Diagnosis Mean for Me?

You’ve been told you have heart valve disease. What does that mean? Can it be treated? Heart valve disease is a disorder that occurs when there is a problem with the function of one or more of your heart’s four valves. Understanding how your heart valves function will help you detect potential problems with your heart sooner rather than later.

How do your heart valves function?

Your heart valves prevent the backward flow of blood as it is pumped into and out of your heart. They act as a one-way inlet of blood on one side of a ventricle and a one-way outlet of blood on the other side of a ventricle. As the heart muscle contracts and relaxes, the valves open and close, letting blood flow into the ventricles and out to the body at alternate times.

What is heart valve disease?

According to the American Heart Association, approximately 5 million Americans are diagnosed with heart valve disorders each year. Heart valve disorders usually arise from two main types of malfunctions:

• Regurgitation (or leakage of the valve). A valve does not close completely, causing the blood to flow backward through the valve. The heart is forced to handle more blood, making it work harder.
• Stenosis (or narrowing of the valve). A valve’s opening becomes narrowed, limiting the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force in order to move blood through the narrowed or stiff (stenotic) valve.

Heart valves can develop both regurgitation and stenosis at the same time and more than one heart valve can be affected simultaneously. When heart valves fail to open and close properly, the implications for the heart can be serious, possibly hampering the heart's ability to pump blood adequately through the body. Heart valve problems are one cause of heart failure. The mitral and aortic valves are most often affected by heart valve disease.

These malfunctions can be caused by a variety of reasons. The causes of heart valve damage vary depending on the type of disease present, and may include the following:

• A history of rheumatic fever.
• Damage resulting from a heart attack.
• Damage resulting from an infection.
• Changes in the heart valve structure due to the aging process.
• Myxomatous degeneration, an inherited connective tissue disorder that weakens the heart valve tissue.
• Congenital birth defect.

Symptoms of Heart Valve Disease

Symptoms of heart valve disease can vary and may resemble other medical conditions and problems. In some cases, mild heart valve disease may not present any symptoms. The most common symptoms include:

• Chest pain.
• Shortness of breath.
• Palpitations caused by irregular heartbeats.
• Fatigue.
• Dizziness or lightheadedness.
• Low or high blood pressure, depending on which valve disease is present.
• Abdominal pain due to gut congestion.

How are heart valve diseases diagnosed?

Heart valve disease can be detected by your doctor if your heart sounds heard through a stethoscope are abnormal. This is typically the first step in diagnosing your heart valve disease. A heart murmur can often indicate valve regurgitation or stenosis. To further diagnose your specific heart valve condition and the extent of valve damage, your doctor may use one of the following tests:

• Electrocardiogram (ECG or EKG)
• Echocardiogram (Echo)
• Two-dimensional echocardiogram (2D Echo)
• Transesophageal echocardiogram (TEE)
• Chest X-ray
• Cardiac catheterization
• Magnetic resonance imaging (MRI)
• Computed Tomography (CT) Angiography

Your doctor will evaluate your individual symptoms and recommend the appropriate diagnostics to come up with the best treatment plan for you.

How are heart valve diseases treated?

Heart valve diseases are treated differently according to your individual health history and diagnosis. Today, minimally invasive surgery between the ribs and less-invasive catheter-based procedures have replaced traditional surgery for the majority of patients. At the UPMC Heart and Vascular Institute, our heart specialists have been instrumental in early groundbreaking clinical trials, which lead to these advances.

Some of the treatment options available at the UPMC Heart and Vascular Institute include:

• Advanced Diagnostic Services
• iSVR: Intercostal Surgical Valve Replacement
• Heart Valve Surgery
• Heart Valve Repair Surgery
• Heart Valve Replacement
• Valvuloplasty
• Double and Triple Valve Surgery
• Mitral Valve Repair Surgery
• Mitral Valve Replacement Surgery
• Right Chest Approach Mitral Valve Repair ("Mini-Mitral")
• MitraClip®
• Aortic Valve Repair Surgery
• Aortic Valve Replacement Surgery
• Aortic Root Surgery (David Procedure)
• Transcatheter Aortic Valve Replacement (TAVR)
• Minimally Invasive Tricuspid Valve Repair Surgery
• Tricuspid Valve Replacement Surgery

Heart valve diseases are diagnosed, treated and monitored through collaboration of your primary care provider, cardiologist and surgeon. It is important that you schedule regular follow-up appointments with your primary care provider or cardiologist to make sure that your heart valves are working properly.

To help prevent heart conditions, including heart valve disease, your doctor may recommend heart-healthy lifestyle changes, including:

• Eating a heart-healthy diet.
• Maintaining a healthy weight.
• Managing stress.
• Exercising regularly.
• Quitting smoking.

If your family has a history of heart disease, talk to your doctor about steps you can take to reduce your risk. Learn more about heart health.