The Valve Clinic at the Prairie Heart and Vascular Institute at HSHS St. Elizabeth’s Hospital in O’Fallon, Ill., is the first multidisciplinary clinic of its kind in the Metro East. Opened last year, a group of cardiologists, heart surgeons and other cardiac care specialists work together as a team to treat valvular heart disease.
Dr. Venkatesh Anjan, MD is an interventional cardiologist with Prairie Cardiovascular and is the director of the valve clinic.
“Valvular heart disease is becoming more prevalent and more treatable,” said Anjan. “Five million people in the U.S. have valvular heart disease; one in 8 over the age of 75 have valvular heart disease; and 25,000 people die from it each year.”
The symptoms of valvular heart disease are different from the more common heart attack. A patient might experience shortness of breath, swelling or sudden weight gain, chronic cough, chest pain, dizziness or fainting. Anjan explained that there are two basic valve problems; either the valve does not open properly, which causes the heart to try to force the blood out; or, the valve does not close properly so blood leaks through. In either case, it creates turbulent blood flow which can be heard with a stethoscope. He said that most patients are referred to the clinic by general practitioners who hear a heart murmur which may be a signal that the valves are not working properly.
Although a heart murmur isn’t really a disease, it can be indicative of an underlying heart or valve problem. Some murmurs are harmless and don’t require treatment. Other murmurs can indicate a problem with the heart muscle or a heart valve. Some heart murmurs can be present at birth and some can develop with age.
Valvular heart disease requires more specialized imaging and diagnosis than other heart problems according to the doctor. When a patient is referred to the clinic, the first step is to do an assessment to determine how much or how little the murmur is affecting daily life. How far can they walk? Can they dress and bathe themselves? How strong is their grip? This initial analysis may be followed by a CT scan or ultrasound.
The clinic’s nurse practitioner and physicians work as a team to determine the best course of treatment for each patient. Treatments include lifestyle changes that can help to ease the symptoms of minor heart valve problems, medications that can delay the need for intervention, open-heart surgery and even the latest minimally invasive techniques such as TAVR (transcatheter aortic valve replacement) and MitraClip, techniques for those who are not candidates for open heart surgery.
— By ALAN J. ORTBALS