How To Treat Heart Valve Disease

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1 The Valve Clinic at Baptist Health Madisonville

2 The Valve Clinic at Baptist Health Madisonville Welcome to the Baptist Health Madisonville Valve Clinic at the Jack L. Hamman Heart & Vascular Center. We are committed to bringing a collaborative approach for diagnosing, managing, and treating heart valve disease. Our heart and valve program offers the skills and experience of board-certified cardiovascular physicians, nurse practitioners, and other healthcare professionals. Your initial visit will include diagnostic testing with sameday results, a comprehensive physical assessment with our Cardiovascular Nurse Practitioner, and a detailed discussion with our Cardiologist and Cardiovascular Surgeon regarding treatment options and management. If surgical intervention is an option for you, we offer conventional, minimally invasive, and catheter-based technologies for your valve repair or replacement. The best approach for you will be discussed in detail with your surgeon. If your heart valve disease is non-surgical, a detailed medical management plan will be established with 6-month monitoring of your heart valve with an echocardiogram and physical assessment.

3 Our Collaborative Heart Valve Team Back row left to right: Georganna Ellis, RDCS; Dr. Wayne Lipson, MD; Dr. T. Mark Stanfield; Dr. Getu Assefa, MD; and Bruce Gaston, RDCS. Front row: Erin Larkins, APRN, ACNP-BC; and Cheri Edelen, APRN, ACNP-BC. Not pictured here: Katie Drury, KCSA; Sherry Winn, KCSA; Rachel Spears, Medical Assistant and Donna Oldham, Medical Assistant. Inside Your Heart The heart contains four chambers. The heart pumps blood by contracting (squeezing blood out of its chambers) and relaxing (allowing blood to enter its chambers). The two upper chambers are called the atria. They receive blood returning from the body through veins. The two atria contract with only a small amount of force, sending the blood to the ventricles; the ventricles are the muscular, lower chambers of the heart. The ventricles contract with greater force, delivering blood to the body by your arteries. The right ventricle pumps blood to the lungs. Of all the chambers BaptistHealthMadisonville.com 3

4 in the heart, the left ventricle does the greatest amount of work. Powerful contraction of the left ventricle sends oxygen-rich blood to all of the body s organs. Human heart valves are tissue-paper thin membranes attached to the heart wall opening and closing with each heart beat. There are four cardiac valves. Their purpose is to ensure that blood flows only in one direction. The heart s valves open at the appropriate times to allow forward flow of blood, but close to prevent backflow of blood. The mitral and tricuspid valves control the flow of blood from the atria to the ventricles. The aortic and pulmonary valves control the flow of the blood out of the ventricles. The characteristic heart sound ( lub, dub ) are caused by the closing of the heart valves the first by closure of the mitral and tricuspid valves and the second by closure of the aortic and pulmonary valves. Heart Valve Problems Heart valves can have three basic kinds of problems regurgitation, stenosis, and atresia. Regurgitation, or backflow, occurs if a valve doesn t close tightly. Blood leaks back into the chambers rather than flowing forward through the heart or into an artery. Stenosis occurs if the flaps of the valve thicken, stiffen, or fuse together. This prevents the heart valve from fully opening. As a result, not enough blood flows through the valve. Some valves can have both stenosis (poor opening) and backflow problems. Congenital heart valve disease develops before birth. This often involves the pulmonary or aortic valves not forming properly. Acquired heart valve disease usually involves aortic or mitral valves that have developed disease over time. Causes of Heart Valve Disease Heart conditions and other disorders, age-related changes, rheumatic fever, or infections can cause acquired heart valve disease. Certain conditions that can stretch and distort the heart 4 The Valve Clinic at Baptist Health Madisonville

5 Illustration Copyright 2013 Nucleus Medical Media, All rights reserved. valves include damage and scar tissue due to a heart attack or other injury to the heart, advanced high blood pressure and heart failure, as well as atherosclerosis (plaque build s up) in the aorta and valve. Age-related changes of men older than 65 and women older than 75 are prone to developing calcium in their heart valves. This stiffens and thickens the valve flaps and limits blood flow through the valve (stenosis). The aortic valve is especially prone to this problem. Rheumatic fever most commonly from an untreated strep infection can cause damage or scarring of the heart valves. The aortic and mitral valves most often are affected. Today s early treatment of strep infections with antibiotics has decreased rheumatic valve disease in America. A rare but serious infection called infective endocarditis can develop in people who already have abnormal blood flow through a heart valve. Common germs that enter the bloodstream and get carried to the heart can infect the inner surface including the heart valves. Germs enter the bloodstream through needles, syringes, and breaks in the skin, and dental procedures. BaptistHealthMadisonville.com 5

6 Signs and Symptoms of Heart Valve Disease The main sign of heart valve disease is a heart sound called a heart murmur. This can be detected by your doctor with a stethoscope. Some heart murmurs are present without heart disease. If you have a murmur further testing is required to determine the presence of valve disease. Other common signs and symptoms include: unusual fatigue, shortness of breath, swelling in your ankles, feet, legs, abdomen, and neck veins. You may experience chest pain with exertion that may be associated with fluttering, racing of the heart, irregular heartbeat, dizziness, or fainting. Diagnostic Tests For Heart Valve Disease Echocardiography is the main test for diagnosing heart valve disease. Sound waves create a moving picture of your heart as it beats using a transducer on the surface of your chest. An echocardiogram can show the size and shape of your heart valves and chambers, how well your heart is pumping blood, and whether a valve is narrow or has backflow. This test is interpreted by a cardiologist. Another test that may be recommended depending on the results of your echocardiogram is a transesophageal echocardiogram (TEE) to get a better image of your heart. During a TEE, the transducer is attached to the end of a flexible tube that travels down your esophagus allowing a more detailed picture of your heart. Relaxation medication is given during this procedure. Additional tests to determine the severity of your heart valve disease include: cardiac catheterization, stress testing, EKG, chest x-rays, and CT scan. 6 The Valve Clinic at Baptist Health Madisonville

7 Treating Heart Valve Disease The goals of treating heart valve disease include preventing, treating, and relieving the symptoms of other related heart conditions, protecting heart valves from further damage, repairing or replacing faulty valves when symptoms become severe or life threatening. Recommendations may include preventing, treating, or relieving symptoms. Smoking cessation and following a healthy diet low in sodium, added sugar, and fat are important. Medications may be prescribed to lower your blood pressure and cholesterol, reduce your heart s workload thereby relieving symptoms, prevent arrhythmias (irregular heartbeats), and thin your blood preventing clots. It is important to protect your heart valves if you ve had previous valve surgery or known valve disease. This includes flossing and brushing your teeth daily, and scheduling regular visits with your dentist. Gum infections and tooth decay can increase your risk of infective endocarditis. Your doctor and dentist may give you antibiotics before dental procedures that could allow bacteria to enter your bloodstream. Repairing or replacing your heart valve may be warranted to prevent lasting damage to your heart and sudden death. Having heart valve repair or replacement depends on the severity of your valve disease, your age and general health, and whether you need bypass surgery in addition to your valve surgery. The Valve Clinic at Baptist Health Madisonville offers a comprehensive approach including same-day diagnosis. We will guide you from the initial evaluation through the final treatment plan. The goal is to minimize your stress and answer your questions while establishing a diagnosis and development of a treatment plan. This approach provides easy access and continuous feedback to the referring physician while offering coordinated and personalized care to you, the patient. BaptistHealthMadisonville.com 7

8 l Hospital Drive l Madisonville, KY BaptistHealthMadisonville.com