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Cardiology

This Heart Month, Show You Care,

Learn the Signs of Heart Valve Disease

February is Heart Month The disease can be com- toms depend on the valve affected and relieve symptoms, and to fix the valve
and Feb. 22, 2019 is plex with the potential of could include: problem, if needed. Heart valve disease
National Heart Valve multiple valves being • Worsening shortness of breath with without symptoms is usually treated with
Disease Awareness Day. I involved and the possibility physical activity or at rest medications to relieve symptoms and with
want to take this opportuni- of having regurgitation and • Fatigue lifestyle modifications to decrease the risk
ty to talk about heart valve stenosis on the same valve. • Dizziness of developing heart failure and long-term
disease. A diseased valve or valves • Loss of consciousness complications. When a patient develops
can create significant pres- • Chest pain or discomfort severe regurgitation or stenosis with symp-
What is heart valve sure changes in the heart • Palpitations toms, heart valve surgery is indicated. All
disease? chambers and the blood • Chest fluttering interventions should be based on individ-
For us to talk about heart flow will not be as efficient. • Leg or ankle swelling. ual risk-benefit assessment. For example,
valve disease, we have to If this happens, the heart Over time, heart valve disease can also If the patient has high or prohibitive risk
understand how the heart BY NEIL I. GALINDEZ, will work harder trying to cause heart failure, stroke or death due to for mortality or complications with heart
and its valves work. The MD compensate and, with time, sudden cardiac arrest. Symptoms do not valve surgery then the recommendation
heart is a complex struc- irreversible damage can always relate to the degree of valve disease. should be a lesser invasive approach like a
ture made out of special- develop. catheter-based therapy.
ized muscle and connective tissue. It has The most commonly involved valves in Evaluation: We now have the technology to deploy
four chambers that fill with blood and adults in the U.S. are the aortic and mitral Individuals with suspected heart valve valves in the heart with small catheters
contract to make circulation possible, two valves. Mitral prolapse occurs when the disease should have a detailed history and that are passed through the peripheral
atria and two ventricles. It also has four leaflets of the valve flop back into the left physical examination done by a cardiolo- blood vessels, usually the femoral arteries.
one-way valves made of thin and pliable atrium during contraction preventing the gist. An echocardiogram (ultrasound of This kind of therapy is only reserved for
connective tissue flaps called leaflets that valve from closing well which can cause the heart) should be done to assess the high risk patients. Surgical intervention is
open and close with each heartbeat. The regurgitation. structure and the function the heart and the gold standard and includes repairing
blood flows from the right atrium to the Many valve problems develop because each valve. The echocardiographic find- or replacing the heart valve. There are sev-
right ventricle through the tricuspid valve, of age-related factors but some valve con- ings, in conjunction with symptom status, eral kinds of valves and materials used for
from the right ventricle to the pulmonary ditions develop due to illnesses, such as are used to determine treatment options this purpose and their use is tailored to the
artery and the lungs through the pulmonic infective endocarditis which is the infec- and timing of valve intervention. In specific valve problem and patient. The
valve, from the left atrium to the left ven- tion and subsequent destruction of a heart patients that need surgical intervention the good news is that valve surgery is very
tricle through the mitral valve, and from valve. Rheumatic fever is another cause of evaluation is best done by a group of spe- likely to provide good outcomes; recovery
the left ventricle to the aorta and rest of the valve disease; it is an inflammatory reac- cialists including cardiologists, structural time is usually 4-8 weeks. During recovery
body through the aortic valve. tion that can occur after a streptococcal interventional cardiologist and heart sur- time patients gradually regain their energy
Heart valve disease occurs if one or more infection of the throat. It can affect the geons to recommend the best therapeutic and return to their normal activity level.
of the heart valves don't work well. The heart by producing inflammation of the option as a group (heart team approach).
valves can have three basic kinds of prob- heart valves with subsequent scarring and Other tests like an electrocardiogram, Dr. Neil Galindez, Cardiothoracic Surgery,
lems: damage. chest x-rays, stress testing and cardiac Tenet Florida Physician Services, can be
• Regurgitation: When the valve does catheterization could be needed in the reached at (954) 714-0686.
not close well and allows for blood to Symptoms of heart valve evaluation of patients with known or sus-
backflow. disease: pected heart valve disease. Patients with Sources:
1. 2014 AHA/ACC Guideline for the Management
• Stenosis - When the valve is thickened In some people the condition stays sta- heart valve disease and changes in symp- of Patients With Valvular Heart Disease. A Report of
or stiff and does not open well. ble throughout their lives without causing toms should have a new evaluation. the American College of Cardiology/American Heart
• Atresia - When the valve is completely problems or symptoms. However, heart Association Task Force on Practice Guidelines.
closed and sealed this is usually a congen- valve disease can worsen with time when Treatment: Circulation. 2014;129:e521–e643
ital problem (something the person was the degree of stenosis or regurgitation The goal of treatment is to protect the 2. Heart Valve Disease. National Heart, Lung and
born with). increases causing symptoms. These symp- heart from long-term complications, to Blood Institute. U.S. Department of Health and
Human Services. November 18, 2013.

Exercise 3 Weeks After Open-Heart Surgery

BY GEORGI MORALES PIPKIN “There is no reason for replacement, or Aortic aneurysms were the primary
metallic valve or a tissue valve. I will fix cause of 9,863 U.S. deaths in 2014,
Without any apparent symptoms, your valve. We’ll fix the aneurysm.” That according to the U.S. Centers for Disease
Antonios Chondros suffered from a heart statement gave Mr. Chondros the confi- Control and Prevention (CDC). The con-
condition that required open-heart sur- dence he needed. “Since I met him (Dr. dition can be described as a balloon-like
gery at Miami Cardiac & Vascular Stewart), I said: This is it. I will do it with bulge in the aorta, the large artery that
Institute. him.” carries blood from the heart through the
Years ago, one of Mr. Chondros’ cardi- Mr. Chondros has always enjoyed chest and torso.
ologists discovered he had a heart mur- exercising and loves playing tennis. But Signs and symptoms of thoracic aortic
mur and a bicuspid aortic valve (BAV) over the last year and a half, these activi- aneurysm can include:
that was also causing an aortic aneurysm. ties have been forbidden by his doctors. • Sharp, sudden pain in the chest or
The BAV is an aortic valve that only has Only three weeks after the open-heart upper back.
two leaflets, instead of three. The aortic procedure, he started going back to the • Shortness of breath.
valve is one of four valves that regulate gym. “I really feel grateful that right now Dr. Allan S. Stewart shakes hands with • Trouble breathing or swallowing.
blood flow through the heart. Mr. I can resume the life that I had a few Antonios Chondros Risk factors for aortic aneurysm
Chondros’ condition evolved to a point years ago,” he says. “I feel really nice Americans,” said Marcus St. John, M.D., include:
that he needed open-heart surgery. about this.” an interventional cardiologist and med- • High blood pressure
The procedure was performed by Allan Mr. Chondros attended the 2018 ical director of the Cardiac • High cholesterol
S. Stewart, M.D., chief of cardiac surgery Miami Heart Walk with his wife and son Catheterization Lab with Miami Cardiac • Atherosclerosis (hardened arteries)
at Miami Cardiac & Vascular Institute. to help raise funds for cardiovascular dis- & Vascular Institute at Baptist Hospital • Smoking
Mr. Chondros said Dr. Stewart was the ease. “It’s only been a few months after of Miami. “Like the AHA, Miami Cardiac
only doctor who said that his heart valve the surgery, and it is great that, you know, & Vascular Institute is dedicated to erad- For more information, visit
could be repaired. you feel normal again.” icating heart and vascular disease baptisthealth.net/heart.
He recalls what Dr. Stewart told him: “Heart disease is the No. 1 killer of all through efforts like this.”

20 February 2019 southfloridahospitalnews.com South Florida Hospital News