Heart Valve Disease
Treatment
If you’ve been diagnosed with heart valve disease, you may need treatment to feel better and to reduce your risk of heart failure, sudden cardiac arrest, and stroke. How you and your doctor treat your heart valve problem will depend on factors such as your age, type of heart valve disease, severity of the damage, symptoms, structure of your heart, other medical conditions, and lifestyle.
Lifestyle changes
Day-to-day choices about taking your medication, seeing your doctor regularly, following a heart-healthy diet, and getting regular exercise can make a difference in slowing the progress of your heart valve disease and maintaining healthy valves. These life-long lifestyle changes are important to follow, as heart valve disease can change over time, sometimes progressing rapidly into life-threatening issues, and small or significant changes in your lifestyle can prevent or delay these changes.
- Schedule regular checkups—You should pursue good follow-up care with your doctor. Your doctor will recommend a schedule for regular checkups and specific tests to monitor your unique condition, which may include the following:
- Regular physical exams to evaluate heart murmurs or rule out abnormal heart rhythms
- Regular echocardiograms to detect thickening heart muscle, enlargement of the heart, or changes in the severity of the valve dysfunction
- Chest X-rays, CT scans, or MRIs to look at the heart and lungs
- Additional procedures like an angiogram/cardiac catheterization to look for changes in valve function, heart muscle strength (ejection fraction), pressures, or blood flow
- Prevent infections—Early treatment of strep throat infection can reduce your chances of contracting rheumatic fever, which can cause your heart valves to thicken. Also, if you have heart valve disease and need to undergo surgical or dental procedures, talk to your doctor or dentist about taking antibiotics before the procedure. Guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) recommend antibiotics before certain dental procedures for people who have undergone valve surgery to prevent bacteria from traveling to your heart valve and triggering an infection.1
- Take your medications—Your doctor may prescribe medication as part of your treatment plan for your heart valve disease. Taking your medication exactly as prescribed is vital for doing everything you can to keep your heart valve disease under control. If you experience any side effects from your medication, let your doctor know. Don’t stop taking your medication without first speaking with your doctor, as doing so can be dangerous.
- Follow a heart-healthy diet and exercise regularly—You should talk to your doctor about appropriate dietary changes and levels of exercise for your heart valve disease, but these general guidelines should be followed:
- Eat a heart-healthy diet and get regular exercise to keep your body strong and to help reduce high cholesterol and high blood pressure, which are risk factors for heart disease
- Quit smoking
- Maintain a healthy weight for good cardiac health
- Restrict your salt intake, which can also help lessen fluid retention and improve symptoms related to heart valve disease
- If you’re on a medication called Warfarin (Coumadin), be mindful of eating green vegetables such as kale, spinach, broccoli, Brussels sprouts, asparagus, and salad greens, among others, since they are rich in vitamin K and interact with the metabolism of the medication
- Take good care of your teeth—When you have valve disease, bacteria from your mouth and gums can travel through the bloodstream and enter the heart, causing infective endocarditis. It's more important than ever to floss and brush your teeth daily and to see a dentist regularly when you have heart valve disease.
Medications
If your heart valve disease is not yet serious enough to require surgery, or if you’ve already had surgery, your doctor may prescribe medication as part of your wellness plan. It’s important to take your medications exactly as your doctor prescribes to have the most effect. Common medications for managing heart valve disease and providing symptom relief include the following:
- Diuretics – These medications help reduce fluid accumulation in your body by increasing fluid loss through urination. Examples include Lasix and Diuril.
- Anticoagulants – These medications thin the blood, help prevent blood clots, and reduce the risk of heart attack or stroke. Examples include Warfarin, Rivaroxaban (Xarelto), and Apixaban (Eliquis).
- Antiarrhythmics – These medications help control a rapid or irregular heartbeat for conditions such as atrial fibrillation (AFib). Examples include Metoprolol, Sotalol, Digoxin, and Amiodarone.
- Blood pressure medications – These medications help keep blood pressure down to relieve a heart overworked by the malfunctioning heart valve. Examples include Lisinopril, Metoprolol, and Diltiazem.
Valve repair or replacement
In some cases, heart valves can be repaired, while in others, they should be replaced. Depending on the nature and severity of your heart valve disease, your doctor may recommend one of the following procedures to repair or replace the problematic heart valve:
- Surgery – Surgery is a common method for repairing or replacing a heart valve.
- Catheter-based (minimally invasive) techniques – These treatment options are usually available to patients who are deemed too sick or have other conditions that make them poor candidates for open-heart surgery. A valvuloplasty is an example of a minimally invasive procedure that can improve blood flow through stenotic valves (valves that don’t open enough) by inflating a balloon within the heart valve.
- Transcatheter aortic valve replacement (TAVR) – TAVR is a newer, less invasive method for replacing the heart valve using a catheter.
- Transcatheter edge-to-edge repair – This is a catheter-based approach to repairing the mitral valve. Examples of this are MitraClip or PASCAL.
- Transcatheter pulmonary valve replacement – This less invasive catheter-based method is frequently used in certain congenital heart diseases (CHDs).
New treatments
The treatment of heart valve disease is constantly changing and improving as new techniques and devices are developed, tested, and approved. Several promising treatments are in the investigational stage but have not yet been approved by the U.S. Food and Drug Administration (FDA). It’s in your best interest to gather as much up-to-date information as possible before deciding the best course of action for you. Talk with your doctor about your treatment options, including new treatments offered in clinical trials. Consider getting a second opinion before deciding on the best treatment option.