Heart Valve Disease

Diagnosis

To diagnose heart valve disease, a healthcare professional will examine you and ask detailed questions about your symptoms and medical history. During a physical exam, a whooshing sound known as a heart murmur may be heard when listening to your heart through a stethoscope. This sound often indicates turbulent blood flow caused by valve abnormalities.

Blood tests and imaging studies are also used to evaluate heart health and identify possible valve problems.

Tests

Common tests used to diagnose heart valve disease include:

• Echocardiogram: Uses sound waves to produce images of the beating heart, showing how blood flows and whether valves are functioning properly. Different types of echocardiograms are used depending on your condition and health.

• Electrocardiogram (ECG or EKG): Records the electrical activity of the heart to identify irregular rhythms or strain caused by valve disease.

• Chest X-ray: Provides images of the heart and lungs, helping detect heart enlargement or fluid buildup that may signal valve issues.

• Cardiac MRI: Produces detailed images of the heart to assess valve structure and disease severity.

• Exercise or stress tests: Monitor how the heart performs under stress from exercise or medication that mimics physical activity.

• Cardiac catheterization: Used when other tests are inconclusive. A thin, flexible tube is guided to the heart through a blood vessel. Dye is injected to make heart structures visible on X-rays and measure blood flow and pressure.

Heart Valve Disease Stages

Once a diagnosis is confirmed, heart valve disease is classified into stages to determine the best treatment plan:

• Stage A: At risk — factors that increase the chance of developing valve disease are present.

• Stage B: Progressive — mild to moderate valve disease without symptoms.

• Stage C: Asymptomatic severe — severe valve disease but no symptoms yet.

• Stage D: Symptomatic severe — severe valve disease with noticeable symptoms.

Treatment

Treatment for heart valve disease depends on your symptoms, disease severity, and whether the condition is worsening. The main goals are to relieve symptoms, prevent complications, and repair or replace damaged valves if necessary.

Treatment options may include:

• Regular health checkups to monitor valve function

• Lifestyle and diet changes, such as limiting salt intake and maintaining a healthy weight

• Medications to manage symptoms or prevent complications

• Surgical or minimally invasive procedures to repair or replace affected valves

Medications

Medications are often prescribed to help manage heart valve disease and reduce symptoms. These may include:

• Blood thinners to prevent blood clots

• Drugs to control blood pressure or heart rhythm

• Diuretics to reduce fluid buildup in the body

Surgery or Other Procedures

When heart valves become severely damaged, surgical repair or replacement may be necessary, even in the absence of symptoms. If you are undergoing surgery for another heart condition, valve repair or replacement can sometimes be performed at the same time.

Types of valve surgery include:

• Open-heart surgery

• Minimally invasive heart surgery

• Robot-assisted heart surgery

The choice depends on your age, overall health, and the affected valve.

Heart Valve Repair

Heart valve repair aims to preserve your natural valve whenever possible. During repair, a surgeon may:

• Patch holes in the valve

• Separate fused valve flaps

• Replace torn or ruptured supporting cords

• Remove excess tissue for proper closure

• Tighten or reinforce the valve’s outer ring

Common valve repair procedures include:

• Annuloplasty: Tightens or reinforces the outer ring of the valve.

• Valvuloplasty: Uses a balloon-tipped catheter to widen a narrowed valve opening. The balloon is inflated to improve blood flow and then removed. Sometimes, clips or plugs are inserted to improve valve function.

Heart Valve Replacement

When a valve cannot be repaired, replacement surgery is performed. The damaged valve is replaced with either:

• Mechanical valve: Made from durable materials, requiring lifelong use of blood thinners.

• Biological valve: Made from animal or human tissue, which wears down over time and may need replacement in the future.

In some cases, a complex surgery called the Ross procedure may be done, where the patient’s pulmonary valve replaces the aortic valve, and a biological valve replaces the pulmonary valve.

While valve replacement traditionally requires open-heart surgery, less invasive methods are now available. For example, transcatheter aortic valve replacement (TAVR) allows for valve replacement through smaller incisions, especially for patients with narrowed aortic valves.

Heart valve disease can often be effectively managed with timely diagnosis, regular monitoring, and appropriate medical or surgical treatment, helping patients maintain a healthy and active life.