In years past, your grandfather may have written off his shortness of breath to old age. Even people diagnosed early in life with heart conditions often didn’t link their decreased energy or their dizziness decades later to their heart conditions.
Today, primary care physicians and cardiologists are tuned into subtle changes that may signal heart valve disease—a condition that can affect people in their 40s or 80s.
“People are taking better care of themselves and living longer,” said Jose Torres, MD, Cardiothoracic Surgeon at The James Family Heart Center at Yavapai Regional Medical Center (YRMC). “That means more people will be diagnosed with heart valve disease and more will be referred to heart surgeons for treatment.”
In fact, one in eight people age 75 and older has moderate to severe heart valve disease, which occurs if one or more of your heart valves don’t work well. To understand why this happens, it helps to know the role healthy heart valves play in the body. The heart has four valves with tissue flaps – also called leaflets – that open and close with each heartbeat. The flaps ensure blood flows in the right direction through your heart’s four chambers and to the rest of your body.
“Think of the leaflets as doors,” said Dr. Torres. “Normally, the doors are very pliable. They open and close to allow blood to flow through the heart and then to the rest of the body. When the doors calcify, their pliability decreases and the heart has to work harder and harder to pump blood to the body.”
Many people with heart valve disease don’t experience noticeable symptoms until the blood flow is significantly restricted. Symptoms that could signal heart valve disease – and should be discussed with your physician – are:
- Chest pain, pressure or tightness
- Palpitations or a feeling of heavy, pounding, or noticeable heartbeats
- A decline in your activity level or reduced ability to do normal daily activities
Here’s a look at conditions that can cause or contribute to heart valve disease:
- Past medical history—A history of diabetes or rheumatic fever and cancer survivors treated with radiation therapy to the chest or sternum are at greater risk for heart valve disease.
- Congenital heart defect—People born with two leaflets, called bicuspid valve, are sometimes diagnosed with heart valve disease in their 40s or 50s.
- Heart murmur—Calcium buildup or a leaky aortic valve can cause a heart murmur, eventually leading to heart valve disease.
Currently, no medicines can cure heart valve disease. However, medications to lower high blood pressure or high cholesterol may be prescribed. Lifestyle changes – giving up smoking, eating a heart-healthy diet, getting regular physical exercise and aiming for your optimal weight – can slow the progress of heart valve disease.
“Heart valve disease is a structural problem that requires surgery,” Dr. Torres said. “Once there’s a heart valve disease diagnosis, the solution is to remove that roadblock with heart valve surgery.”
Dr. Torres calls valve replacement the “gold standard” for treating heart valve disease. During these open heart surgeries, patients are placed on a heart bypass machine to keep their hearts working during surgery. Cardiothoracic surgeons, like Dr. Torres, then replace the heart’s calcified valve with a new, artificial valve.
Beginning in November at YRMC, people considered too high risk for heart valve replacement surgery because of their poor health may be eligible for Transcatheter Aortic Valve Replacement (TAVR). The minimally invasive TAVR procedures will take place in YRMC’s recently opened Hybrid Operating Room (OR).
YRMC’s Hybrid OR – considered one of the nation’s best – combines a surgical suite with a permanently integrated medical imaging facility. In this state-of-the-art OR, a patient’s heart blockage can be diagnosed and then immediately repaired with a minimally invasive procedure, like TAVR. If the real-time imaging shows the patient requires surgery, YRMC’s heart team is ready to perform the procedure in the Hybrid OR.
“This is a big step forward for YRMC’s Heart Program,” said Dr. Torres. “The entire team – from physicians to nurses to administration – is very excited and optimistic about TAVR, the Hybrid OR and YRMC’s technologically advanced Heart Program. It’s great that people can stay in their community for this state-of-the-art technology.”