Guide to Heart Valve Disease

What is Heart Valve Disease?

When we talk about heart valve disease, we’re speaking about a group of conditions that can involve any of the four valves in the heart:

  • Tricuspid valve
  • Pulmonic valve
  • Mitral valve
  • Aortic valve

Each of these valves helps regulate the flow of blood circulating throughout the body:

  • The tricuspid valve lets blood from the body pass through the right side of the heart
  • The pulmonic valve lets blood flow from the right side of the heart into the lungs (aka the pulmonary system)
  • The mitral valve lets blood coming back from the lungs pass through the left side of the heart
  • The aortic valve lets blood flow from the left side of the heart to the rest of the body, via the central artery, the aorta

Problems with any of these valves can disrupt blood flow and put stress on the heart, lungs or the rest of the circulatory system.  Issues can occur in any of the four valves, and usually come in one of the following two varieties:

  • Valve Regurgitation: the valve becomes leaky, and blood flows back in the wrong direction
  • Valve Stenosis: the valve becomes stiff, making it difficult for blood to flow forward

What Happens if You Have Heart Valve Disease?

Symptoms of heart valve disease will vary depending on the type (ie which valve, and whether its leaky or stiff) and the severity.  Early on, some people may have no symptoms at all, but as the condition evolves, it can lead to dizziness, fatigue, difficulty breathing, chest pain, and other problems. If left untreated, bigger problems can occur, like blood clots, stroke and heart failure.

Who Gets Heart Valve Disease?

Heart Valve Disease can develop at any stage of life, though it most commonly affects people over 75.

Some people have congenital heart valve issues, meaning they were born with valve issues. Congenital valve issues usually involve the pulmonic or aortic valve, and may occur in the context of other congenital heart issues as well.

Acquired valve issues–those that develop later in life–can result from many causes, including: 

  • The normal aging process (for women over 65 and men over 75, there is a tendency for calcium to build up in heart valves)
  • Damage to the heart from past heart attacks, heart failure or trauma
  • Infections (infections of the heart valve is called endocarditits)
  • Cholesterol build-up

In cases of acquired valve disease, it’s most often the mitral or aortic valve that is affected.

How Do You Know if You Have Heart Valve Disease?

For people without any symptoms, the only sign of valve disease may be an irregular heart sound that a doctor or nurse can hear with a stethoscope.

For those who do have symptoms, an examination with a heart specialist can clarify the diagnosis.  After a thorough interview and physical exam, a cardiologist who suspects valve disease is present will usually recommend an EKG and chest x-ray.  These can help establish whether there is any existing damage to the heart or nearby anatomy that may be the cause or result of valve disease.  Depending on those results, more tests may be used to confirm the diagnosis, including:

  • Echocardiogram: an ultrasound of the heart that can also visualize blood flow
  • Stress Test: a test that looks at the heart’s response to exercise
  • Cardiac MRI: an imaging test that creates a detailed view of the inside of the heart
  • Cardiac Catheterization: this is a procedure that can help diagnose the severity of valve disease and related conditions like coronary artery disease

How is Heart Valve Disease Treated?

Treatment for heart valve disease involves either the repair or replacement of the existing valve. The decision to repair vs replace depends on both the extent of the damage and the particular valve. Repairs are more common in mitral and tricuspid valves, while aortic and pulmonic valves usually require replacement.

Repair or replacement can be done as a traditional, open surgery, in which surgeons operate through an incision in the chest, or it may be done through smaller incisions on the side of the chest (this is called minimally-invasive surgery). 

In some cases, doctors can treat the damaged heart valves by threading tools–including replacement valves–through the bloodstream. These are called transcatheter procedures.  

Traditional and minimally-invasive valve surgeries are performed by cardiac surgeons, while transcatheter procedures may be performed by cardiac surgeons or interventional cardiologists.

Heart valve disease that is mild or not causing symptoms may not need immediate treatment, and can instead be monitored with regular visits to a general cardiologist. 

If I Have Heart Valve Disease, What Are My Next Steps? 

Our cardiac surgeons can help you figure out if a heart valve surgery or procedure is the best option for you. We routinely care for high-risk patients, many of whom are considered inoperable at other centers. We are also known for our unparalleled commitment to complete patient care – we know that having a cardiac operation is a major life event, and our team of surgeons, cardiologists, therapists, and coordinators will walk you through every step of your evaluation, treatment, and recovery. Our goal is to make you feel comfortable and confident right from the start, and keep you informed and involved in every aspect of your care throughout your stay with us.

Request an appointment today.

Next Steps

If you have heart disease and need help, we’re here for you. To get started today, call (212) 305-2633 or use our appointment request form.

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