Heart Valve Disease: Diagnosis and Treatment


Irving Herling, MD
Director, Clinical Cardiology
Main Line Health

Nearly 5 million people are diagnosed with heart valve disease each year, according to the American Heart Association.  People do not always show symptoms, but your doctor may detect valve disease during your annual physical.

The first signs of heart valve disease are often found when your doctor listens to your heart and hears a distinctive sound indicative of the condition. To better evaluate the cause and severity of that finding, he or she may request an echocardiogram which uses sound waves to show your valves opening and closing, and the impact of those valves on blood flowing through your heart.

Once your diagnosis is made, your doctor may request further testing, including:

  • an electrocardiogram (ECG), a painless test where electrodes are attached to the skin to measure the electrical activity of the heart
  • a stress test, a treadmill test that monitors a patient’s heartbeat, breathing rate, blood pressure and ECG changes while exercising
  • cardiac catheterization, an invasive procedure where a catheter is threaded into the heart chambers to detect valve issues

There are two main types of valve problems. Valves can be stenotic – too narrowed or hardened to open fully, or incompetent or leaky – too loose to close completely. Both concerns disrupt the one-way flow of blood through the heart.

Many people with heart valve disease require no treatment, other than regular monitoring to make sure the condition does not worsen. If your condition does require treatment, your doctor may recommend:

  • antithrombotic medicines, like aspirin, to prevent blood clots
  • valve surgery to repair or replace a damaged valve – the mitral valve is the most commonly repaired valve, while aortic and pulmonic valves generally require replacement
  • Medications to forestall the need for replacing or repairing your valve

If you or a loved one has been diagnosed with aortic stenosis, usually a condition associated with aging, the only course of treatment used to be open heart surgery to replace the aortic valve. Now, a procedure called Transcatheter Aortic Valve Replacement (TAVR) may be an option. With TAVR, the valve is replaced via a catheter and is much less risky.

Join Dr. Herling live at Lankenau’s  Web Chat, tonight at 7 p.m.: Living With Heart Valve Disease: Your Own & Your Loved One’s. This web chat will also feature a patient who has recently recovered from mitral valve repair surgery. Sign up now.

Get Heart Smart and win a Whole Foods gift card from Philadelphia magazine at www.facebook.com/LankenauMedicalCenter.

A Primer on Heart Valve Disease

Irving Herling, MD
Director, Clinical Cardiology
Main Line Health

Each year, about 5 million people are diagnosed with heart valve disease, according to the American Heart Association. The condition disrupts the one-way flow of blood through the heart, forcing it to work harder to circulate blood through the body.

ANATOMY OF THE HEART

Before delving further into heart valve disease, a quick refresher on the heart: The heart is divided into four chambers—the upper right and left atria, and the lower right and left ventricles. The heart also has four valves—the pulmonary and tricuspid on the left, and aortic and mitral on the right. Each valve has a set of flaps, known as leaflets or cusps. Valves keep blood flowing in one direction through the atrium into the ventricles, opening and closing with each heart beat. Read more »

Heart Screenings for Athletes

Jason T. Bradley, MD
Cardiologist, Lankenau Heart Group

It’s common knowledge that regular exercise is a prescription for a heart-healthy life. And with a few exceptions, working out is considered safe for almost anyone. Still should some athletes—be they weekend warriors, seasoned marathoners or college players—have a heart screening? If you fall into any of the categories listed below, that answer might be yes.

1. You have a strong family history of heart disease, or heart attack at a young age. Heart attacks under the age of 55 for men and 65 for women is considered young. If you have parents or siblings who fall into this group, you should consider talking to a cardiologist to get a better picture of your heart health and discuss your fitness program.

2. You discover you have high blood pressure. People who have high blood pressure are generally encouraged to exercise to help lower it, but if you have untreated high blood pressure, physical activity can actually exacerbate the situation. If you are concerned about elevated blood pressure, consider having a cardiac screening.

3. You have physical symptoms indicative of a heart problem when you workout. If you have experienced dizziness, loss of consciousness, chest pain, shortness of breath, nausea, cold sweat, or heart rhythm abnormalities while exercising, you should definitely talk to your doctor about your symptoms. They could be signs of an underlying heart condition.

If you’re an athlete concerned about your cardiac health, there’s no risk in having a heart screening. Talking to your doctor might just give you that competitive edge you need to stay healthy.

Join Dr. Bradley live at Lankenau’s Wednesday Web Chat, July 24 at 7 p.m.: Athletes at All Levels & Cardiac Risk. Sign up now.

Stay Heart Smart. Ask your Heart Health questions via Lankenau’s Facebook page for your chance to win a Whole Foods gift card.

Weekend Open Houses

You won’t want to miss these weekend open houses.

8901 Atlantic Ave., Margate
Open house: July 20, noon-2 p.m.
Price: $1,595,000
Bed: 5
Bath: 4
3,000 sq. ft.

1101 James Lane, Berwyn
Open house: July 21, 2-4 p.m.
Price: $1,999,000
Bed: 5
Bath: 3.3
6,119 sq. ft.

openhouse copy600 Brintons Bridge Rd., West Chester
Open house: July 21, 2-4 p.m.
Price: $1,365,000
Bed: 5
Bath: 5.2

 

729 Lindy Lane, Bala Cynwyd
Open house: July 21, 2-4 p.m.
Price: $874,000
Bed: 3
Bath: 4.1
4,213 sq. ft.

9101 Ventnor Ave., Margate
Open house: July 21, noon-2 p.m.
Price: $1,090,000
Bed: 5
Bath: 3.1

Heart Conditions in Young Athletes

Jason T. Bradley, MD
Cardiologist, Lankenau Heart Group

From time to time, the news reports a tragic story of a young athlete who dies suddenly during a competition or practice. Although such occurrences are extremely rare, the cause of young athletes’ sudden cardiac arrest is generally an undetected heart defect or problem with the heart’s electrical circuitry.

The most common cause of sudden death in young athletes is hypertrophic cardiomyopathy (HCM), a thickening of the heart muscle that makes it harder to pump blood. This genetic condition is generally asymptomatic—the first sign of a problem is often the person’s sudden death.

Because cardiac conditions and defects are often asymptomatic, they can be difficult to detect before it’s too late. In some cases, young people will experience unexplained fainting after engaging in high activity, as well as seizures, or subtler signs like shortness of breath or chest pain. These symptoms, however, are also often associated with asthma.

So what is a parent to do? All high school students are required to have a physical prior to playing sports, and if your doctor suspects an underlying issue, he or she may order an electrocardiogram (EKG), a non-invasive test that looks at the heart’s electrical activity and can detect dangerous, irregular heart rhythms. (In some countries, including Italy, all student athletes are required to have an EKG before participating in sports.)

If you have a family history of sudden cardiac death before age 35, or you are concerned about your child’s health as it relates to sports, discuss it with your doctor before they take to the field.

Join Dr. Bradley live at Lankenau’s next Wednesday Web Chat, July 24 at 7 p.m.: Athletes at All Levels & Cardiac Risk. Sign up now.

Stay Heart Smart. Ask your Heart Health questions via Lankenau’s Facebook page for your chance to win a Whole Foods gift card.

Weekend Open Houses

Check out these weekend open houses in the city, suburbs and shore.

8901 Atlantic Ave., Margate
Open house: July 13, noon-3 p.m.
Price: $1,595,000
Bed: 5
Bath: 4
3,000 sq. ft.

7721 Saint Martins Lane, Philadelphia
Open House: July 14, 1-3 p.m.
Price: $1,099,000
Bed: 6
Bath: 3.1
3,600 sq. ft.

825 Lewis Lane, Blue Bell
Open House: July 14, 1-3 p.m.
Price: $2,950,000
Bed: 5
Bath: 6.1

 

103 Anthony Way, West Chester
Open House: July 14, 1-3 p.m.
Price: $1,299,000
Bed: 5
Bath: 5.2

 

1138 Norsam Road, Gladwyne
Open House: July 14, 2-4 p.m.
Price: $1,000,000
Bed: 4
Bath: 3.1
3,659 sq. ft.

TAVR May be an Alternative to Open Heart Surgery for Aortic Stenosis

Paul M. Coady, MD
Primary and Interventional Cardiovascular Medicine
Lankenau Heart Group

If you or a loved one has been diagnosed with severe aortic stenosis—a condition where the aortic valve narrows, restricting normal blood flow—a new treatment option may be available to you.

Aortic stenosis is generally found in patients age 75 and older. When it becomes severe, it can be debilitating, limiting a patient’s day-to-day activities. In the past, the only treatment option for severe aortic stenosis was valve replacement through open-heart surgery—a serious, multi-hour surgery with a lengthy recovery period. About a third of people diagnosed with severe aortic stenosis, however, especially elderly patients, are not suitable candidates for this surgery.

A new technology, transcatheter aortic valve replacement (TAVR), has expanded the treatment options for people with severe aortic stenosis. TAVR involves a small incision in the thigh, through which a balloon-expandable heart valve is delivered via catheter to open the affected valve. Once the valve is in place, the heart begins to function normally.

In 2011, the FDA approved TAVR as a treatment for patients with severe symptomatic aortic stenosis who were not eligible for open-heart surgery. In October 2012, the FDA made the treatment available to high-risk patients as well.

Join Dr. Coady live at Lankenau’s next Wednesday Web Chat, July 10 at 7 p.m.: Heart Health & Your Family History. Dr. Coady will also respond to your questions about the TAVR procedure as an alternative to open surgery for treating aortic stenosis. Sign up now.

Get Heart Smart. Enter the Heart Smart Challenge via Lankenau’s Facebook page for your chance to win a Whole Foods gift card.

 

All in the Family

When discussing heart disease, “family history” falls at the top of the list of risk factors. But what does that mean? Should you be more concerned if your mother, a smoker, died of a heart attack at age 57, or if three of your grandparents had high cholesterol and hypertension, but died in their 80s and 90s? How deep should you delve into your family history and when should you get concerned? Read more »

Weekend Open Houses

Whether you’re looking for a Victorian in the city, a large estate in the suburbs, or a beach house, you’re bound to find what you’re looking for at one of these weekend open houses.

349 Pond View Road, Devon
Open house: 6/30 2-4 p.m.
Colonial farmhouse on four acres.
Price: $1,599,000
Bed: 5
Bath: 5.2
5,856 sq. ft.

7721 Saint Martins Ln., Philadelphia
Open house: 6/30, 1-3 p.m.
Queen Anne Victorian with original details.
Price: $1,175,000
Bed: 6
Bath: 3.1
3,600 sq. ft.

1218 Lakemont Rd., Villanova
Open house: 6/30, 2-4 p.m.
Large circular staircase, spacious living room and big picture window.
Price: $935,000
Bed: 5
Bath: 4.2
4,292 sq. ft.

4 Westbrae Lane, Greenville
Open house: 6/30 1-3 p.m.
Located on a private lane by Valley Garden Park and Hoopes Reservoir.
Price: $979,900
Bed: 4
Bath: 3.1 | 4,225 sq. ft.

23 S. Union, Margate
Open House: 6/30 10 a.m.-noon
Meticulous home with ocean views
Price: $1,375,000
Bed: 5
Bath: 3.1

Kenneth Day Home For Sale

Kenneth Day is known for his International Style houses, an architectural movement known for its emphasis on abstraction, minimalism and balance. Included in his portfolio is this 2,600-square-foot home in Conshohocken. Situated on almost three acres, this Kenneth Day home for sale features slate floors in the entry hall, a great room with great views, and a spacious kitchen. The four bedrooms all have wonderful natural light and closet space, two of which have steamship-like balconies. Outdoors, you’ll find nice gardens, clay tennis courts and a pool.

2088 Harts Ln., Conshohocken
Price: $1,050,000
Bed: 4
Bath: 3
2,610 sq. ft.

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