February is American Heart Month and many experts in the medical community continue to seek to raise more awareness to heart valve disease, which occurs when the heart’s valves don’t work properly.
An emphasis on heart valve disease is expected to be a highlight of events taking place on Thursday, Feb. 22, which is designated as National Heart Valve Disease Awareness Day.
Medical experts said heart valve disease affects at least five million Americans, but three in four U.S. adults know little about the illness, which is treatable but can be deadly.
Warning signs are key to detection, experts warn.
“Symptoms are often unrecognized at first and tend to be rather nondescript,” said Dr. Eric Sarin, co-director of the Inova Structural Heart Program at Inova Heart and Vascular Institute in Fairfax, Virginia. “Since it tends to affect people as they get older, they might not think of much of mild fatigue or shortness of breath.
“Patients will often think the symptoms are part of ‘getting older’ and it’s only with the benefit of hindsight after they have been treated that they can realize how limited they were by their valve disease,” said Sarin, who will be featured at a Feb. 22 heart valve awareness event at the Inova Heart and Vascular Institute.
Warning signs of heart valve disease typically begin with shortness of breath and fatigue that weren’t usually present during daily activities, Sarin said.
“As it progresses, the symptoms will become more pronounced and the patient will notice a significant change in their stamina and physical capability,” he said. “At its most severe, patients may have chest pain, fainting spells, or leg swelling and fluid overload related to heart failure.”
The heart valves lie at the exit of each of four heart chambers and maintain one-way blood flow through the heart. The four heart valves make sure that blood always flows freely in a forward direction and that there is no backward leakage. Blood flows from the right and left atria into the ventricles through the open mitral and tricuspid valves.
When the ventricles are full, the mitral and tricuspid valves shut. This prevents blood from flowing backward into the atria while the ventricles contract. As the ventricles begin to contract, the pulmonic and aortic valves are forced open and blood is pumped out of the ventricles through the open valves into the pulmonary artery toward the lungs, the aorta and the body.
When the ventricles finish contracting and begin to relax, the aortic and pulmonic valves snap shut. These valves prevent blood from flowing back into the ventricles. This pattern is repeated, causing blood to flow continuously to the heart, lungs and body.
While Sarin said there’s no definitive evidence that African-Americans are any more or less at risk for heart valve disease, others said the lack of Black clinical research participants doesn’t help.
Some also argue that African Americans aren’t treated equally as other patients.
“African Americans are treated less aggressively than their Caucasian counterparts, but we know that based on published data, if they do get the proper procedure, their outcomes are just as good as Caucasians,” said Dr. Aaron Horne of the Cardiac and Interventional Group in Texas and interventional cardiologist at the Methodist Dallas Medical Center.
“We [also] know that over a five-year period we have published data that demonstrates that [new] technology have only penetrated the African-American community by four percent and that’s further striking when you have about a 10 percent refusal rate in the African-American population,” Horne said.
Treatment outcomes are just as good between Blacks and whites when African Americans receive access to technology, Horne said.
The prognosis for most cases of valve disease remains excellent with the appropriate treatment, Sarin said.
“And we have never had more effective options for treating heart valve disease than we have today,” he said.
Heart valve disease can have a significantly negative impact on the people it affects, often made worse by delayed diagnoses, Sarin said.
“Timely evaluation and referral to appropriate specialists is of the utmost importance,” he said. “The technology to treat valve disease has blossomed in the last decade and we know have more minimally invasive options than ever before.”