Transcription:

Adam Ragusea (Host): One in four American deaths is the result of heart disease. That’s according to the Centers for Disease Control. Heart disease of course can mean a lot of things, but one of the big ones is problems with your heart valves. Scary stuff. What symptoms should you be on the lookout for? Let’s ask Dr. Jeffery Snyder, cardiothoracic surgeon at Florida Heart and Lung Institute. This is Helmet of Health the podcast from HCA Capital Regional. Dr. Snyder, first of all, when we talk about heart valve problems, what do we mean?

Jeffery Snyder, MD (Guest): The heart valves control the flow of blood in the heart and they prevent blood from going backward after the heart has pumped the blood out to the body or out to the lungs. When the valves have problems, they can either be leaky, in which case blood does go backwards through the valve and that’s called regurgitation. Or they can become narrowed, which is called stenosis which is like pinching a garden hose making it harder and harder for the heart to push the blood out of the heart. So, valves go bad either with leaky valves or valves that are too tight.

Host: Okay. And what would it feel like if either of those things are happening to my heart?

Dr. Snyder: They can feel very different. A leaky valve may only cause irregular heartbeats or palpitations initially, but as the valves get worse, if they do get worse, then leaky valves usually cause shortness of breath and fatigue or low energy and low stamina. So, someone who could walk out to their mailbox 100 yards away, now is having trouble making that trip.

Host: Okay so it’s hard for me to do basic physical activity, I’m getting short of breath. I feel like I can’t catch my breath. When you say palpitation, let’s not take that for granted. What does that mean?

Dr. Snyder: Fluttering of the heartbeat or sometimes a rapid heartbeat, or my heart has skipped a beat, all those sort of things where people notice an irregular heart rhythm.

Host: Okay so I would just like feel my heart suddenly start pumping really fast even though I’m just sitting at my desk.

Dr. Snyder: That’s right. Or you might feel that oh my heart has sort of skipped a beat and then it had a real hard beat also is a form of a palpitation.

Host: Well Dr. Snyder, when you think about heart disease, you think about problems that are often the result of lifestyle, eating a really bad diet, of not getting enough exercise. These problems that you are talking about leaky or pinched off heart valves are these things that come about because I’ve been having too many cheeseburgers?

Dr. Snyder: Usually not as a matter of fact. The cheeseburger scenario, the diet and the inactivity really affect the coronary arteries with blockages in the arteries. But for the valves, it’s more of a random occurrence unless there is an infection.

Host: Okay so what does cause it?

Dr. Snyder: With stenosis, which is narrowing of the valves, that’s most commonly in the aortic valve and that is a slowly progressive process in which calcium is deposited in the valve leaflets which cause the leaflets to become very, very thick and lose their elasticity and flexibility so that instead of flopping open when the heart squeezes blood out of it, they are stiff and the opening is very small, making it hard for the heart to push blood through that small opening.

With valves that become leaky, those also are from infection or just a degenerative process but not really related to our activities. And then the last one is a common problem and becoming less so is a rheumatic heart disease or rheumatic mitral stenosis and that’s becoming less common because strep infection causes that, and it’s being much better treated.

Host: So, about what age do these kinds of problems start to affect people?

Dr. Snyder: Most of these chronic, slow, degenerative processes affect people starting at around age 60.

Host: All right. So, if I’m an older person and I’m having these symptoms that you described, physical activity that used to be really easy for me is now just making me feel like I can’t catch my breath, or I feel like my heart is just racing out of nowhere or skipping a beat; obviously I need to go see my doctor. If in fact it is a problem with the heart valve; how treatable are these problems?

Dr. Snyder: Fortunately nowadays there are multiple different ways to treat those valve problems. First, we want to diagnose you correctly so almost always after seeing the cardiologist and having the physical examination; the next step would typically be an echocardiogram which is a sonogram. And that shows the details of these valves very, very well and from that, they can pretty well tell you which valve it is, which problem it is and then to rule out coronary artery disease, most people get a heart catheterization because they are in the age group where coronary artery disease is common.

And then the treatment can be a variety of things. Sometimes it’s mild enough that just medications would be enough for that. Sometimes it involves a complete open heart operation with a valve replacement. And nowadays, for people there are some catheter based options where a catheter can be threaded into the heart from the groin, a valve or a device on the end of that catheter can be used to either bring some leaflets together in the mitral valve in particular, that are floppy and pull those together and prevent the leakage from occurring.

Or if the valve is tight, they can put a big balloon through that valve and then inflate the balloon and crack that valve open which used to be what we did surgically.

And then for the aortic valve, the newest thing is a complete valve replacement with the valve threaded into the right position from the groin, it’s squeezed down really tight on a catheter and then it is manipulated into the right position and then a balloon forces it wide open into the walls of the aorta and that actually stays in place and functions exactly like a valve replaced with an open heart operation.

Host: Wow. So, a lot of things you can do short of a full open heart surgery. That’s really exciting.

Dr. Snyder: That is true.

Host: All right Doc, I appreciate it. That’s Dr. Jeffery Snyder, cardiothoracic surgeon at Florida Heart and Lung Institute. Thanks for listening to Helmet of Health the podcast from HCA Capital Regional. Go to www.capitalregionmedicalcenter.com to get connected with Dr. Snyder or another provider. If you found this podcast helpful, please share it on your social channels. That would warm our heart valves and be sure to check back soon for the next podcast.