Structural Heart Disease

What is structural heart disease?

Structural heart disease is a broad term for any issue with the structure of your heart. It means there is an abnormality in the structure or function of the valves, walls, chambers or muscles in your heart.

You can be born with structural heart disease (congenital) or it can develop as you age. Structural heart disease can lead to other health problems over time if left untreated.

What are the types of structural heart disease?

The main types of structural heart disease are:

• Heart valve disease, a problem with any of the four valves that open and close to control blood flow.
• Cardiomyopathy, a disease involving the heart muscle.
• Congenital heart disease, structural heart problems that you have at birth.

Who might get structural heart disease?

Structural heart disease can affect anyone no matter their gender, ethnicity or race. Depending on the issue, it may be more common in people with a family history of structural heart disease. It may also be more common in children whose birth parent had:

• Exposure to industrial solvents during pregnancy.
• Rubella during their first trimester of pregnancy.
• Taken certain medications or drank alcohol during pregnancy.
• Viral infections during pregnancy.

Your risk of structural heart disease also increases as you get older. More than 10% of adults over age 75 have structural heart disease.

How common is structural heart disease?

Heart valve disease is the most common type of structural heart disease. It affects about 2.5% of all people in the United States. This includes valvular regurgitation (leaking) or stenosis (narrowing). Mitral valve regurgitation is the most common valve disease in the United States, though aortic valve stenosis is also very common. More than 2 million people in the U.S. have a leaky heart valve.

In addition, about 1.4 million adults and 1 million children in the U.S. have a congenital heart condition. Congenital heart conditions are the most common type of birth defect in the U.S. They affect nearly 1% of births (about 40,000 babies) each year.

Lastly, as many as 1 in 500 people in the U.S. may have cardiomyopathy. There are many reasons for cardiomyopathy, including coronary artery disease, consequences of viral infection, environmental exposures (such as alcohol) and inherited causes.

How does structural heart disease affect my body?

Structural heart disease makes it more difficult for your heart to pump blood to the rest of your body. Blood contains nutrients and oxygen that your body’s cells need to survive. It also carries waste out of the cells.

You may damage your organs and other tissues if your heart isn’t able to pump enough blood to the rest of your body. This can lead to many other health problems and symptoms.

What causes structural heart disease?

You can be born with structural heart disease. Your heart may develop abnormally due to problems with your body’s DNA or genetics.

Structural heart disease can also develop later in life due to:

• Aging, which can cause calcium deposits on your heart valves.
• Alcohol or drug addiction.
• Aortic aneurysm.
• Autoimmune disease, such as lupus and rheumatic fever.
• Cardiovascular disease or heart attack (myocardial infarction).
• Diseases that damage the heart, such as amyloidosis, hemochromatosis or sarcoidosis.
• Endocarditis.
• Endocrine diseases, such as diabetes and thyroid disease.
• High blood pressure (hypertension).
• High-dose radiation exposure.
• Marfan syndrome.
• Muscle conditions, such as muscular dystrophy.
• Plaque buildup in arteries (atherosclerosis).

What are the symptoms of structural heart disease?

You can have structural heart disease and not have any signs or symptoms. As the disease progresses, symptoms may include:

• Chest pain, tightness or pressure.
• Dizziness, lightheadedness or fainting (syncope).
• Fatigue.
• High blood pressure (hypertension).
• Irregular heartbeats (arrhythmia).
• Kidney dysfunction.
• Shortness of breath (dyspnea).
• Swelling in the abdomen, ankles or feet (edema).

How is structural heart disease diagnosed?

During pregnancy, your healthcare provider may use a fetal echocardiogram to detect structural heart disease. They can do this at or before birth. This imaging technique uses sound waves to form a picture of the baby’s heart.

In children and in adults, your provider may hear a heart murmur when they listen to your heart with a stethoscope. If your provider suspects you have structural heart disease, they will refer you to a cardiologist. The cardiologist will perform tests including:

• Cardiac catheterization: During cardiac catheterization, your cardiologist inserts a small tube through an artery in your groin. Then, they thread it to your heart. The cardiologist tests pressures within your heart chambers. And, they may look at close-up images of your heart and blood vessels.
• Coronary angiogram: Your cardiologist will use cardiac catheterization to perform angiography. They inject dye through the catheter into your blood vessels. Your cardiologist uses an X-ray to view blood flow through your heart, arteries and valves.
• Echocardiogram: Echocardiogram (also called an echo) uses soundwaves to create images of your heart’s chambers and valves. This test examines your heart’s pumping action.
• Electrocardiogram: An electrocardiogram (also called an ECG or EKG) measures the electrical activity of the heart.
• Exercise stress test: During anexercise stress test, you walk or run on a treadmill. While you exercise, your provider monitors your heart.
• Holter monitor: A Holter monitor records your heart’s electrical activity for 24 to 48 hours while you perform your daily activities.
• Imaging tests: A chest X-ray, CT scan or cardiac MRI takes pictures inside your chest to look for structural problems.

ECG and echocardiogram are the most common tests done to evaluate for structural heart disease.

How is structural heart disease treated?

Some types of structural heart disease won’t need treatment. But a provider will need to monitor your condition throughout your lifetime.

Your provider may treat other types of structural heart disease with:

• Medications.
• Minimally invasive heart procedures, which use only small incisions to repair or replace a defective valve.
• Open-heart surgery, where a surgeon opens your chest wall to access your heart for valve replacements or a heart transplant.

How can I reduce my risk of structural heart disease?

When you are pregnant, you can reduce the risk of your child having a congenital heart disease if you:

• Ask your doctor’s advice about taking medications for chronic conditions. These may include diabetes or a seizure disorder such as epilepsy.
• Quit smoking and using tobacco products.
• Stop drinking alcohol.
• Stop recreational drug use.
• Take 400 micrograms of folate or folic acid every day.

You can reduce your risk of certain heart valve diseases and cardiomyopathy by making healthy lifestyle choices:

• Achieve and maintain a healthy weight.
• Eat a heart-healthy diet.
• Exercise.
• Limit your intake of alcohol don't use recreational drugs.
• Manage other health conditions such as high blood pressure, diabetes and thyroid disease by following your healthcare provider's instructions.
• Reduce stress.

What is the outlook if I have structural heart disease?

The prognosis for structural heart disease depends on:

• How long you’ve had the condition.
• The severity of the condition.
• Which condition you have.
• Your other health issues.

Many people with structural heart disease lead long, full lives. However, you may be at higher risk of heart infections. Talk to your provider about taking antibiotics during dental or surgical procedures. This can help reduce your risk of endocarditis.

How do I take care of myself with structural heart disease?

You can keep your heart healthy and reduce complications by:

• Making sure your healthcare providers know about your heart condition and any medications you take.
• Talking to your healthcare providers well in advance if you plan to become pregnant. They will help you assess risks and find the best way to manage your condition during your pregnancy.
• Visiting a cardiologist on a regular basis to monitor your condition.

A note from Cleveland Clinic

Structural heart disease is a problem with the structure of your heart. You can be born with structural heart disease or develop it later in life. Structural heart disease types include cardiomyopathy, congenital heart disease and heart valve disease. You may not need treatment for your condition. Or your provider may recommend medications or surgery. Healthy lifestyle habits and regular monitoring by a cardiologist can help you lead a full life.