Central Arkansas Cardiology

Valvular Disease

Just like your home plumbing system, normal heart function is dependent on several valves. The heart valves separate the four major chambers and keep the blood going in the correct direction. Heart valves can become leaky (regurgitant or insufficient) or narrowed (stenotic, stenosis). Patients with valve disease often have heart murmurs.

Valve problems can be due to defects in the valves architecture which are originating since birth (congenital) or acquired over time. It can also be related to other illnesses such as hypertension or rheumatic fever.

When valves are stenotic, pressure builds up and the heart has to work harder than normal to move the blood forward. In Aortic Stenosis, for example, the main pumping chamber has to work very hard to pump the blood out the aorta to the body. As it progresses, affected individuals may feel tired and breathless, dizzy, or experience chest pain. Sometimes surgery is required to replace the aortic valve.

Leaky or regurgitant valves result in back-up of blood. This makes the heart less efficient since it has to pump more and often the chambers enlarge and result in higher pressures, fatigue, breathlessness, and arrhythmias.

Mitral valve prolapse (MVP) is a common condition in which the mitral valve tissue is ‘floppy' and may be associated with a leaky mitral valve (‘mitral regurgitation'). It is more common in women and may be found in young age. Palpations and even chest pains have been linked to this valve problem and a careful evaluation is sometimes warranted. Most patients with MVP do not have symptoms, do not have severe valve regurgitation, and, therefore, will not have problems. Some patients may be advised to take antibiotics at the time of dental procedures to minimize the already low risk of heart valve infections. Please speak with your cardiologist to determine if you may require this.

Following a careful physical examination and cardiologist evaluation, Echocardiography is an essential test to further evaluate the valve problem. Echocardiography is often repeated over time to track any changes and aid in the timing of any needed surgery or intervention.

Several physicians at Central Arkansas Cardiology have a particular interest and expertise in the management of valvular disease. Medications can often be used to help delay progression of valvular disease. Antibiotics at the time of ‘unclean' procedures like at the dentist may be advised to prevent heart infections. If surgery is required, great advances have been made using ‘minimally invasive' surgical techniques to repair or replace the affected valve.

Please visit these sites for more information and speak with your Central Arkansas Cardiology physician.

American Heart Association, Mitral Valve Disease and MVP
NHLBI, MVP
American Heart Association, Aortic Regurgitation
American Heart Association, Aortic Stenosis

Exercise and Rest Myocardial Perfusion Imaging (also called a MIBI, Cardiolyte, Myoview, or Thallium stress tests): The noninvasive assessment of coronary artery disease via treadmill stress testing which can detect blockages significant enough to prevent adequate blood flow to the heart during exercise. These tests also definitively examine any damage done to the heart from prior heart attacks and can determine viability of heart muscle which may return to normal function if appropriately revascularized (i.e. with angioplasty or bypass surgery.) They also provide a highly accurate assessment of the contracting performance of your heart - both regional wall motion and ejection fraction of the left ventricle.
Pharmacologic Stress Myocardial Perfusion Imaging (Adenosine stress test) Uses medications which simulate the physiologic effect of exercise (instead of exercise) in those who are unable to perform on a treadmill test. The same assessment of coronary blood flow and left ventricular function may then be performed as in the exercise perfusion imaging.
Radionuclide Ventriculography (also called a RNV or MUGA test): The noninvasive ability to evaluate the contraction pattern of your heart. We can determine the left ventricular global and regional function including calculation of left ventricular ejection fraction, assessment of regional wall motion, aneurysms and pseudoaneurysms.