Heart Valve Disease
A routine physical exam turns up a murmur your doctor wants investigated. Shortness of breath you have been attributing to age or being out of shape keeps getting worse on ordinary tasks. You feel more fatigued during activities that used to be no trouble at all. These symptoms may indicate you may have issues with your heart valves that require evaluation. Getting an accurate diagnosis is the first step toward understanding your options.
How Heart Valves Work and What Goes Wrong
Your heart has four valves (the aortic, mitral, tricuspid, and pulmonary) that open and close with each heartbeat to keep blood moving through the heart’s chambers and out to the body in the right direction at the right time. When a valve is healthy, blood flows cleanly through with minimal leakage and without restriction.
Heart valve disease falls into two broad categories.
Stenosis
Stenosis means a valve has become narrowed or stiffened, creating resistance that forces the heart to push harder to move blood through.
Regurgitation
Regurgitation means a valve does not close completely, allowing blood to leak backward through the opening. Both problems force the heart to work harder than it should, and over time that extra strain can weaken the heart muscle.
Common Valve Conditions
Aortic stenosis
Aortic stenosis is the most common valve disease in older adults. The aortic valve, which releases blood from the left ventricle into the aorta, becomes calcified and stiffened over time. In significant stenosis, blood flow out of the heart is restricted, leading to chest pain on exertion, shortness of breath, and sometimes fainting. Left untreated, severe aortic stenosis carries a serious prognosis.
Mitral Regurgitation
Mitral regurgitation occurs when the mitral valve, which sits between the left atrium and left ventricle, does not close properly. Blood leaks back into the upper chamber with each beat. Over time, the chambers enlarge to compensate, and heart function can gradually decline if the condition is not monitored and treated.
Mitral Stenosis
Mitral stenosis is a narrowing of the mitral valve opening, often caused by rheumatic fever decades earlier. It restricts blood flow from the left atrium into the left ventricle and can cause breathlessness, fatigue, and fluid retention.
How We Evaluate It
Echocardiography is the primary diagnostic tool for heart valve disease. This ultrasound of the heart provides detailed images of each valve’s structure and movement, as well as measurements of how much blood is flowing through and whether any leakage is occurring. A stress echocardiogram can reveal how a valve behaves under the demands of exercise. In some cases, cardiac catheterization is used to measure pressures inside the heart and to assess the coronary arteries before a procedure is considered.
Ultrasound
Stress Echocardiogram
Cardiac Catheterization
How We Treat It
Not all valve problems require intervention right away. Mild valve disease is often managed with regular monitoring and medications to control symptoms and protect the heart while the condition remains stable. We watch closely for signs that the disease is progressing.
When a valve problem becomes significant enough that the heart is at risk, intervention becomes necessary. Richmond Heart and Vascular Associates offers access to advanced options through our Structural Heart Program.
Transcatheter Aortic Valve Replacement (TAVR)
For patients with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) provides a minimally invasive approach that delivers a new valve through a catheter rather than open-heart surgery.
MitraClip Procedure
For appropriate candidates with mitral regurgitation, the MitraClip procedure can repair the valve without surgery.
Our structural heart team works closely with each patient to determine which approach is best suited to their anatomy and overall health.
Why Choose Richmond Heart and Vascular Associates
Schedule an appointment online or call Richmond Heart and Vascular Associates at 804.800.6600. Our offices are open Monday through Friday, 8:00am to 5:00pm.
Echocardiography available in-office for thorough and timely valve assessment
Access to TAVR and MitraClip through our Structural Heart Program for patients who qualify
Collaborative care between cardiologists and structural heart specialists under one practice
Convenient locations in Chesterfield, Mechanicsville and Hopewell, with personalized follow-up throughout treatment