More than 5 million Americans have heart valve disease (HVD), yet too few people are familiar with the condition known as the "mystery killer." Heart Valve Disease Awareness Day (February 22) began in 2017 after a national survey showed only 1 in 4 people had even some awareness of the disease.
While some types of HVD are not serious, it's important to understand because it usually progresses slowly with little to no warning, and can cause sudden and unexpected death. People age 70 and older are the most commonly affected — among Americans age 70 and older, more than half have HVD — but it can also be present at birth.
"Many people who need surgery for HVD have known they have a murmur, but most do not know the murmur is due to an abnormality in the heart valves," says Dr. Seemal Mumtaz, cardiothoracic surgeon affiliated with Sharp HealthCare. "By the time people develop severe symptoms, they may have irreversible heart damage. It's important to catch HVD early to receive maximum benefit from surgery."
In most cases, HVD involves a damaged valve that doesn't open or close properly. When a valve doesn't open, blood can't flow through; this is called stenosis, or a sticky, narrowed or stiff valve. When a valve doesn't close tightly, blood leaks backward, which is called regurgitation or backflow. Any of the heart's four valves can have stenosis, regurgitation or both, but the aortic and mitral valves are most commonly affected.
When blood flow is limited by HVD, the heart has to work harder, resulting in symptoms like shortness of breath; feeling tired; leg swelling; chest pain with activity; and dizziness and fainting. People with HVD don't always have symptoms though.
"The symptoms of HVD are not as intense as a heart attack, which makes people believe that their shortness of breath or decreasing stamina is due to aging or being out of shape," Dr. Mumtaz says. "But if you're unable to do activities that you were able to do last year, it's important to contact your doctor. It only takes a doctor to listen to a heart with a stethoscope to detect a murmur. The presence of a murmur then leads to an ultrasound of the heart, which is not an invasive test and can be done in 15 to 20 minutes to diagnose HVD. Once HVD is detected, it can be treated by cardiac surgeons and cardiologists to prevent any further damage to the heart."
HVD is usually successfully treated through repair or replacement with an artificial valve; a cardiac surgeon will recommend repair or replacement depending upon the seriousness of the disease. The first artificial valves were used in the 1960s by Dr. Dwight Harken, known as the father of heart surgery, who removed shrapnel from the hearts of wounded World War II soldiers.
Since then, there have been many advancements, including longer lasting valves and minimally invasive techniques, such as transcatheter aortic valve replacement (TAVR), an alternative to open-heart surgery. While open-heart surgery is the gold standard treatment for severe aortic valve stenosis, there are patients who are too high risk for open-heart surgery and can benefit from TAVR.
"In the early days of heart surgery, most people had to have their hearts stopped with a heart-lung machine," Dr. Mumtaz says. "With modern advancements, we're able to perform surgery on a beating heart. Modern-day heart surgery is safe and effective at getting people back to the activities they love."
Learn more about treatments for heart valve disease at Sharp HealthCare.
For the news media: To talk with Dr. Mumtaz about heart valve disease for an upcoming story, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.