Heart Valves

Some heart valve diseases, like bicuspid aortic valve, pulmonary valve disease and atresia (when the valve doesn’t form properly and stays blocked) are congenital (something you’re born with). And sometimes valve diseases are acquired (developing later in life). Complications from a previous heart condition or surgery, an infection from another illness (such as rheumatic fever or endocarditis), pulmonary hypertension or simply aging can cause valve disease.

The two most common types of heart valve disease are stenosis (when the opening to your valve gets narrow or stiff) and regurgitation (when your valve doesn’t close completely and leaks).

Symptoms of heart valve disease might not be that noticeable at first. You might be very tired, have swollen ankles or feel like your heart is skipping a beat. If the disease is further along, you might have chest pain, shortness of breath or feel dizzy. You can also have heart valve disease for a long time and not feel any symptoms at all.

At your appointment, your healthcare provider will ask about your medical history, your family medical history, what symptoms you’re having and how bad they are. Your provider will also do a physical exam and may also listen to your heart through a stethoscope. If your provider hears a murmur (abnormal whooshing sounds), that might mean there’s a potential blood flow problem in one of your heart’s valves. Not all murmurs are something to worry about, but it’s important to find out what’s causing the murmur and to check on it over time.

If you have a heart murmur and/or are experiencing symptoms, your provider may order more tests to help determine which valve is having problems, what’s causing the damage and how far along the disease is. These tests may include:

• Echocardiogram (Echo): This test uses high-frequency sound waves (ultrasound) from a handheld wand on your chest to take pictures of your heart’s valves and chambers and see how well your heart’s pumping.
• Electrocardiogram (EKG): Your provider will put sticky electrode pads on your chest, arms and legs to measure your heart’s electrical activity.
• Computed tomography (CT) scan: This test takes three-dimensional pictures of your heart to show how blood is flowing through your heart and blood vessels.
• Magnetic resonance imaging (MRI): An MRI uses powerful magnets and radio waves to take moving pictures of your heart as it’s pumping to see if there’s unusual blood flow through your heart.
• Cardiac catheterization (cardiac cath or angiogram): Your provider will put a small, flexible tube (catheter) into your leg or arm and pass it through a blood vessel to the inside of your heart to see how it’s working.
• Chest X-ray: A chest X-ray uses a focused beam of radiation to look at your heart.
• Exercise stress test: Your provider will have you walk on a treadmill or pedal a stationary bike while hooked up to an EKG machine to check your heart’s activity when it’s working hard.

The best treatment options for you will depend on several things, including which valve is having problems (aortic, pulmonary, mitral, bicuspid or tricuspid), the type of valve disease you have, how badly the valve is damaged, your age and medical history. If your symptoms are mild, your provider may simply keep an eye on your condition with regular checkups and repeated testing. If your condition is more serious, treatment options might include:

• Medication: If you think of your heart valves like plumbing in your house, you know that eventually a faulty valve will need to be repaired or replaced. The same is true for your heart valves. So, medicines aren’t a cure, but they can help relieve mild symptoms, make your heart pump better and lessen the chance of further valve damage. Your provider might recommend diuretics (water pills), beta blockers or anticoagulants (blood thinners).
• Minimally invasive procedures: Our providers use minimally invasive or robotic procedures whenever possible, including transcatheter aortic valve replacement (TAVR), Transcatheter edge-to-edge valve repair for mitral or tricuspid valve (TEER) and transcatheter pulmonary valve replacement (TPVR). In these procedures, your valve is replaced using a small tube (catheter) that’s put into an artery in your groin or neck instead of making a large incision (cut) in your chest. Your provider will tell you if TAVR, TEER or TPVR is an option for you. There may be an option to replace your mitral or tricuspid valve percutaneously (nonsurgical procedure where the replacement is done using a catheter).
• Surgery: If your valve is severely damaged, you may need surgery. Your provider will decide if the valve can be repaired without using artificial parts or if it needs to be replaced with a biological valve (from a cow or pig) or a mechanical valve (made from carbon and metal).

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can be stressful and intimidating. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat or shop, how to get to and from the airport, or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

If left untreated, heart valve disease can severely impact daily life and even become life-threatening. With the right care from the best team, a healthy heart is within reach. Cleveland Clinic’s heart specialists and surgeons are the best of the best. Heart disease of any kind doesn’t wait. If you suspect you might have a problem with your heart, call your healthcare provider today.