Valvular Disease: What’s Happening Inside Your Heart

Your heart works quietly and tirelessly, beating thousands of times a day to keep blood flowing throughout your body. Most of the time, this process goes so smoothly you never give it a second thought. But when something disrupts that flow — even slightly — your heart needs to work harder to keep up. And over time, that extra strain can affect how you feel and how well your body functions.

Heart valve disease is one of those conditions that often develops slowly and silently. You may feel fine for years before symptoms appear. That’s why understanding the basics can make a meaningful difference in your long-term heart health.

AdventHealth Pepin Heart Institute’s Chief of Cardiothoracic Surgery, Erol Belli, MD, says heart valve disease is often misunderstood.

“Valvular heart disease is a testament to not judging a book by its cover,” he says. “You may not see any signs of it on the outside, but that doesn’t mean damage isn’t going on.”

What is Heart Valve Disease?

Valvular heart disease refers to a damaged or defective heart valve. There are four kinds of heart valves, including:

• Aortic (located between the left ventricle and aorta)
• Mitral (located between the left atrium and left ventricle)
• Pulmonary (located between the right ventricle and pulmonary artery)
• Tricuspid (located between the right atrium and right ventricle)

Valvular disease is often caused by a congenital defect, which is a structural problem present at birth. But the condition can also arise from other factors, such as infection complications. For instance, endocarditis, an infection that affects the heart, causes bacteria to grow on the heart valves, destroying the tissue.

Still, getting older is a major culprit, Dr. Belli says. The normal “wear and tear” of aging can lead to inflammation and other changes that can cause the valves to stiffen, thicken or narrow.

Types of Valvular Disease

The primary function of heart valves is to let blood flow without obstruction. A damaged valve may narrow, called stenosis, blocking blood flow through the heart. The valve may also leak, called regurgitation, allowing blood to flow backward.

Damaged valves can also cause leaflets — the tissue flaps that open — to become stretchy and fail to close fully, a condition called prolapse. In addition, valvular atresia can develop if a heart valve fails to form an opening before birth.

The most common form of valvular disease is aortic stenosis, which occurs when the aortic valve narrows and can’t open fully. Mitral valve prolapse — when the mitral valve leaflet stretches and can’t completely close — is another frequent problem.

All forms of valvular disease reduce blood flow and cause the heart to work harder. Left untreated, valve problems can gradually limit daily activities, affect overall quality of life and increase the risk of serious complications, including heart rhythm disorders like atrial fibrillation, stroke and heart failure.

Signs of Heart Valve Disease

One problem with getting prompt treatment for valvular disease is that it doesn’t cause symptoms right away. Instead, they typically develop as the condition worsens.

Symptoms of valvular heart disease tend to be wide-ranging, but frequently include:

• Chest pain or pressure
• Dizziness
• Edema (swelling of the feet, ankles or abdomen)
• Fatigue
• Heart palpitations (skipped heartbeats or a flip-flop feeling)
• Shortness of breath
• Weakness

“It’s important for people to have regular check-ups with their primary care doctor or cardiologist who can identify the symptoms of valvular disease,” Dr. Belli says. “The doctor can then send the patient to a center that regularly handles this complex condition.”

He adds: “When it comes to valvular heart disease, you want to be in a center where the expertise is, and where you have high-volume surgeons.”

Expert Heart Care at AdventHealth Pepin Heart Institute

Choosing an experienced center and team for your heart care is critical. In fact, Pepin Heart Institute at AdventHealth Tampa was the first hospital in the Tampa area and one of the first in the nation to perform the Transcatheter Aortic Valve Replacement (TAVR) procedure, a minimally invasive treatment option for those unable to undergo open-heart surgery. Learn more about minimally invasive treatment options Pepin Heart Institute offers for heart disease.

The team also personalizes treatment for each patient, considering factors such as age, overall health and long-term goals.

Treatment options for valvular disease may include:

• Medication management
• Valve repair
• Valve replacement

Treating valvular heart disease involves restoring the natural flow of blood in the body and making the heart work more efficiently, Dr. Belli says. That usually leads to more energy and longer-term survival.

“If you have heart valve disease, your life expectancy goes down, but when we fix it, your life expectancy goes back to normal,” he says.

Learn more about heart valve disease treatment at AdventHealth Pepin Heart Institute

About Dr. Belli

Erol Belli, MD, is a board-certified cardiothoracic surgeon at AdventHealth Tampa’s Pepin Heart Institute. He serves as the chief of cardiothoracic surgery and cares for patients ages 18 and older. Dr. Belli is a helper at heart, drawn to cardiac surgery because it allows him to combine his passion for helping others with his fascination for the intricacies of the heart.