Heart valve disease, also known as valvular heart disease, refers to conditions that affect one or more of the heart’s four valves: the aortic valve, the mitral valve, the pulmonary valve and the tricuspid valve. An estimated 5 million Americans are diagnosed with valve disease every year.
The purpose of the heart valves is to keep blood flowing in one direction through the body. Each valve opens and closes with every heartbeat. When they don’t function the way they should, this leads to inefficient heart muscle function, elevated pressures inside the heart and lungs and reduced blood flow to the rest of the body. If left untreated, the decreased efficiency and function of the heart can cause severe disability and even death.
Causes and Risk Factors
Valve disease can be caused by a number of factors, and each valve may be affected differently. Conditions affecting the heart valves can be congenital, meaning they were present at birth, or the result of wear and tear on the heart. Causes of heart valve disease can include:
- Heart muscle failure
- Heart attack
- Coronary artery disease
- Chest radiation for cancer treatment
- Calcification in the heart related to aging and other risk factors
Rheumatic fever is the most common cause of heart valve disease worldwide, but the availability of antibiotics makes this much less common in the U.S.
The presence of certain risk factors can make you more likely to develop valvular heart disease. These include:
- High cholesterol or lipids, also called dyslipidemia
- Chronic kidney disease
- Chest radiation
Heart Valve Disease Symptoms
The most common symptoms of heart valve disease include:
- Shortness of breath, especially during exercise
- Swelling in the feet and legs, also known as edema
- Reduced tolerance for exercise
Heart murmurs are often harmless, but they can also be a sign of valvular heart disease. A heart murmur is an abnormal sound heard during a heartbeat caused by turbulent blood flow within the heart.
If you experience any of these symptoms and/or your health care provider detects a heart murmur, you should see a specialist to be evaluated for heart valve disease.
Types of Heart Valve Problems
Many patients with mild to moderate heart valve conditions can live relatively normal lives with regular monitoring from their providers. More severe valve problems can get progressively worse over time and can be life-threatening, depending on the patient’s age and overall health. While the most common heart valve problems are mitral regurgitation and aortic stenosis, there are several types of valvular heart disease.
- Aortic valve disease, including regurgitation (also known as insufficiency), stenosis and bicuspid aortic valve disease
- Mitral valve disease, including prolapse, regurgitation and stenosis
- Pulmonary valve disease, including regurgitation or stenosis
- Tricuspid valve disease, including regurgitation and stenosis
- Multiple and mixed valve disease
- Endocarditis, an infection of the inner lining of the heart, usually involving one or more of the heart valves
- Some patients might be born with valve problems, also called congenital heart disease. Our Adult Congenital Heart Disease Program is one of the few of its kind in the state and treats adults with all types of congenital heart defects.
Echocardiogram and Other Valve Disease Diagnostics
An accurate diagnosis is the first step in effectively treating valvular heart disease. Our Valvular Heart Disease Program has the latest imaging technology needed to accurately diagnose and evaluate all types of valvular disease, including:
- Echocardiogram – An "echo" uses ultrasound technology to take images of your beating heart. It provides valuable information about your heart and how blood flows through it. Types of echocardiography include transthoracic (TTE), transesophageal (TEE), intracardiac (ICE), three-dimensional (3D) and strain. Learn more about the types of echocardiograms we offer.
- Stress Echo/Doppler Exams – An echocardiogram is done before, during, and after the heart is stressed, either through exercise or with medications. The Doppler exam, which creates black and white or color images, uses sounds waves to measure the direction, amount and speed of blood flow through the heart and across valves.
Our sonographers are specifically trained to image for valve diseases, and take extra steps to evaluate the severity of the valvular disease and produce a more detailed evaluation. Other diagnostic tests may be used in evaluating and diagnosing valve disease, including:
- Cardiac catheterization
- Cardiac nuclear medicine imaging
- Diagnostic CT angiography (CTA)
- Exercise stress test
- Cardiac MRI
Heart Valve Disease Treatment Options
Our heart and vascular experts offer the entire spectrum of care for valvular disease treatment, including nonsurgical options. Generally, those living with a heart valve condition should aim to reduce their overall risk factors for heart disease, including controlling blood pressure, not smoking and exercising regularly.
For some patients, medication may be enough to improve valve function. This is most commonly the case when heart valve dysfunction results from another condition, like severe high blood pressure or severely weakened heart muscle function.
The type of medication you’d be prescribed depends on the type and severity of your condition. The most important medications for patients with heart valve disease help to control heart rate, blood pressure, heart muscle function and water weight. Examples include diuretics and blood thinners, which can reduce blood pressure, remove excess fluid from the blood and lessen the heart’s work. Our specialists use evidence-based, long-term monitoring to watch your condition for any changes.
Heart Valve Replacement or Repair
If a patient’s diagnosis is severe and their symptoms persist or worsen despite proper medication, surgery may be needed to repair or replace the heart valve. Heart valve replacement can be done through a minimally invasive surgery such as transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR).
Minimally invasive procedures are always our team’s first choice for surgical treatment, if it’s appropriate for the patient. Patients with underlying medical conditions, multiple heart problems or other factors may be better suited for traditional open heart surgery.
This transcatheter procedure uses a balloon to open or widen the problem valve to restore normal blood flow in patients. During the procedure, the physician inserts a balloon via a catheter through a vein in the patient’s leg to the problem valve in the patient’s heart. Once in place, the balloon is inflated to open or widen the valve and restore normal blood flow. Valvuloplasty can potentially be used for all types of valve stenosis (aortic, mitral, tricuspid and pulmonic).
Because we are part of an academic medical center, our patients have access to treatments not readily available at other institutions. We also participate in significant clinical research trials to find new and more effective treatments for heart and vascular disease.
Expertise in Patient-Centered Care for Valvular Disease
Our heart valve disease experts treat the full range of structural heart conditions. Structural heart disease includes conditions affecting the valves and vessels of the heart wall.
Our team, led by doctors representing multiple specialties, provides the individualized care you need. Our specialists work collaboratively, using best-practice techniques and weekly "valve conferences" to gather multiple opinions and to make sure you get the best treatment recommendations.
We offer quick access to full evaluation, including consultations with cardiologists and cardiac surgeons, in one convenient location. We plan visits as conveniently as possible for our patients. We emphasize patient education and want patients to participate in their treatment decisions. Our team also works closely with referring physicians to coordinate consultation, treatment and follow-up care.
Second Opinion Program
If you or a loved one have been diagnosed with heart valve disease and have concerns about your diagnosis or treatment options, our team of experts offers a robust second opinion program. We can give you peace of mind that you are on the right treatment path or help you learn about treatment alternatives you did not know were available. Learn more about our Second Opinion Program.
When needed, we can assist international patients in arranging for their care at Froedtert Hospital in Milwaukee, Wisconsin.