Ryan P. Daly, MD FACC, FASE, is a Franciscan Health board-certified cardiologist at Franciscan Physician Network Indiana Heart Physicians and a Fellow of both the American Society of Echocardiography (FASE) and the Society of Cardiac Magnetic Imaging (FSCMR). Dr. Daly is also a member of the heart valve team at Franciscan Health Indianapolis. Dr. Daly answers your questions and shares expert insight about heart valve disease.
Valve disease can be caused by many things. Sometimes people are born with a predisposition to valve disease. Sometimes the heart valves become diseased and stop functioning properly.
Some valve disease may be caused by an infection. Others are degenerative caused by wear and tear, age, blood pressure or cholesterol. It is difficult to reliably determine exactly how leaky or how narrowed the valve is just by listening to it. These valves frequently require imaging with an ultrasound test called an echocardiogram.
Regurgitation is a term used to describe a heart valve that allows blood to leak backward. This leaking causes the heart to do more work than necessary. When the leak becomes severe, the affected chamber will frequently dilate (enlarge). Sometimes the heart function can get weak or impaired, leading to heart failure.
Another problem affecting heart valves is a narrowing of the valve, called stenosis. Blood has difficulty leaving a narrowed opening. This occurs when the valve does not open completely.
Think of putting your thumb over the end of a hose. The leaky valves or narrowed valves cause an acceleration of blood which can be heard with a stethoscope, producing a characteristic sound, or heart murmur. The best way to think of this is again, to think of the sound a garden hose makes when you cover the end of it with you thumb. The sound changes to something like a hiss.
Diseased heart valves may cause symptoms including:
In general, valve disease cannot be treated with medicines or pills. If you have been told that you have a heart murmur, you should be evaluated by a physician. If you have been told that you have moderate or severe heart valve disease, it is reasonable to seek consultation with a cardiologist. In some cases it may be wise to perform an echocardiogram to assess the severity of the valve disease.
Once valvular heart disease has been confirmed, the cardiologist will talk to you about what to expect next. The cardiologist will continue to monitor the heart, valve function and symptoms to determine if further intervention is needed. Some patients require surgical valve replacement or repair (open heart surgery). Other patients are best served with less invasive procedures where valves can be replaced or repaired using a catheter, called TAVR or Mitra-Clip.