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What Happens When Heart Valves Don't Function Properly
Your heart keeps your blood pumping, but malfunctioning heart valves can cause other problems. Dr. Charles Klodell, Cardiothoracic Surgeon at Florida Heart and Lung Institute, discusses how heart valves can malfunction.
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Learn more about Charles Klodell, MD
Charles Klodell, MD
Dr. Charles T. Klodell is a cardiothoracic surgeon that specializes in heart and lung surgical procedures including minimally invasive aortic and mitral valve repair or replacement, aortic aneurysm repair, transcatheter aortic valve replacement (TAVR) and open heart surgery. He has a special interest in minimally invasive procedures, valve repair, and innovative uses of technology and pharmacology to alleviate patient discomfort.Learn more about Charles Klodell, MD
Transcription:
Prakash Chandran (Host): Your heart is the workhorse of your body; pumping blood 24-7 to keep you alive. But what happens if your heart’s valves aren’t opening and closing normally? And what can you do about it? Let’s talk about it with Dr. Charles Klodell, a cardiothoracic surgeon at Florida Heart and Lung Institute.
This is Helmet of Health, the podcast from North Florida Regional Medical Center. I‘m Prakash Chandran. So, Dr. Klodell, what can you tell us about the heart valves and the role they play in keeping blood flowing throughout our bodies?
Dr. Charles Klodell, MD (Guest): I think that in general, most people probably know that there’s four valves in the heart. Three of our heart valves have three leaflets, one has only two leaflets. The mitral valve only has two leaflets. And in the most simplistic terms, the heart valves are supposed to do two things. When the heart wants to push blood through them, they are supposed to open up widely and let the blood go through without any resistance and then when the heart wants to contract and push blood out of that chamber, they are supposed to close and not let it go backwards. And that applies to all four valves.
So, for example, the aortic valve, when the left ventricle wants to push blood out to the body; that’s your main pumping chamber and is going to push it out to all of your body. The aortic valve is supposed to open and then when the heart is ready to relax and fill for the next beat; the valve is supposed to close and not let it run back into the heart. And so essentially that’s really what your heart valves are supposed to do.
Host: And so how do we know when things aren’t working properly?
Dr. Klodell: Yeah so really, I think what this is getting at is that sometimes patients will develop dysfunction of either the aortic valve or the mitral valve most commonly. Sometimes, the tricuspid valve. But what they’ll experience is symptoms of heart failure and these are things like they can’t lie down flat, they get short of breath with exertion. They notice that they have to get up more frequently through the night to go to the bathroom. They notice some swelling in their ankles. Those kinds of things. their exercise tolerance is decreased. All those can be symptoms of a heart condition and a heart valve problem.
Host: Got it. So, if they are experiencing some of these conditions, talk a little bit about how this is diagnosed. Do they go to their primary care physician? Do they go to the emergency room? Talk a little bit about that.
Dr. Klodell: Yeah, I think first and foremost, the primary care physicians are the lifeblood of our healthcare system and everybody should have a reliable good physician that they feel confident in and they see them frequently kind of for their well checks but also, it’s their first line of defense when they feel like something maybe isn’t quite right. Many of those physicians have a long track record of seeing and listening to those particular patients and I say seeing and listening because when they put their stethoscope on that patient’s chest, they are going to say wow, I hear something I hadn’t heard before. They are going to hear a new murmur. Which is when that valve that is either leaking or not opening properly creates turbulence in the flow of the blood and that’s what we actually hear in our stethoscope is that turbulent flow.
Most often then the primary care doctor is going to order an echocardiogram which is an ultrasound intended to let us look at those valves a little better and see what the velocities across them are doing. And then if appropriate, they will send that patient either to a cardiologist or to a cardiothoracic surgeon or whatever. Now other patients may already have been seeing a cardiologist. Oftentimes, particularly in older patients, they will have atrial fibrillation or something like that and they are chronically followed by a cardiologist and if that’s the case; then certainly they could see their cardiologist directly and get an echocardiogram and see what’s going on.
Host: Okay so if there are issues with a heart valve, what are some of the treatment options available to patients?
Dr. Klodell: Well 2019 is a great time because we have so many options available to us now. As time has progressed, and we’ve acquired more and more technology; now there are both open surgical, minimally invasive and then even catheter-based solutions for almost every valvular problem in the heart. And our goal is really to look at every patient’s problem and say what is the least invasive, least injurious way that we can resolve this patient’s problem and get them back to the highest functioning quality of life. It’s about not only the length of life we’re going to extend them but also the quality of life that we can provide them and how rapidly we can provide it with the least amount of disruption to their daily activities.
Host: I really love that philosophy and it sounds like it’s an extremely high level of care. But I want to talk about prevention for a second. What can people do to avoid a lot of these heart valve issues that we’re talking about?
Dr. Klodell: Well so some of the developing heart valve issue is just in your genetics. It’s in your DNA. There’s not much you can do about that. They always say you can pick your friends, but you can’t pick your parents. So, the genes you have is the genes that you have. Now, having said that, there are somethings for example, if you have calcium forming on your valves and things there may be some medicines that your doctor has put you on to reduce the rate of calcification. If you have high blood pressure, controlling the blood pressure can help slow the deterioration of the valves.
So, we can’t stop the genetics that someone got but maybe we can get the most mileage out of them that’s possible.
Host: Yeah, it is pretty amazing the number of treatment options available to patients in 2019. And I know that even some of them will have patients walking out the very next day. Is that correct?
Dr. Klodell: Absolutely. With the new technology some of which we have that’s commercially available, some of which we are very fortunate to be a trial enter for some of the FDA sponsored research of new devices coming into the country allows us to treat people with what I term the absolute cutting edge technology and match the right treatment to the right patient. And so, as you say, many times these patients are only in the hospital overnight and are back to full function within a couple of days. Which is just amazing compared to what we were doing ten or fifteen years ago.
Host: All right Dr. Klodell. I really appreciate your time today. That’s Dr. Charles Klodell, a cardiothoracic surgeon at North Florida Regional Medical Center. Thanks for checking out this episode of Helmet of Health. Head to FLHeartAndLung.com to get connected with a provider. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.
Prakash Chandran (Host): Your heart is the workhorse of your body; pumping blood 24-7 to keep you alive. But what happens if your heart’s valves aren’t opening and closing normally? And what can you do about it? Let’s talk about it with Dr. Charles Klodell, a cardiothoracic surgeon at Florida Heart and Lung Institute.
This is Helmet of Health, the podcast from North Florida Regional Medical Center. I‘m Prakash Chandran. So, Dr. Klodell, what can you tell us about the heart valves and the role they play in keeping blood flowing throughout our bodies?
Dr. Charles Klodell, MD (Guest): I think that in general, most people probably know that there’s four valves in the heart. Three of our heart valves have three leaflets, one has only two leaflets. The mitral valve only has two leaflets. And in the most simplistic terms, the heart valves are supposed to do two things. When the heart wants to push blood through them, they are supposed to open up widely and let the blood go through without any resistance and then when the heart wants to contract and push blood out of that chamber, they are supposed to close and not let it go backwards. And that applies to all four valves.
So, for example, the aortic valve, when the left ventricle wants to push blood out to the body; that’s your main pumping chamber and is going to push it out to all of your body. The aortic valve is supposed to open and then when the heart is ready to relax and fill for the next beat; the valve is supposed to close and not let it run back into the heart. And so essentially that’s really what your heart valves are supposed to do.
Host: And so how do we know when things aren’t working properly?
Dr. Klodell: Yeah so really, I think what this is getting at is that sometimes patients will develop dysfunction of either the aortic valve or the mitral valve most commonly. Sometimes, the tricuspid valve. But what they’ll experience is symptoms of heart failure and these are things like they can’t lie down flat, they get short of breath with exertion. They notice that they have to get up more frequently through the night to go to the bathroom. They notice some swelling in their ankles. Those kinds of things. their exercise tolerance is decreased. All those can be symptoms of a heart condition and a heart valve problem.
Host: Got it. So, if they are experiencing some of these conditions, talk a little bit about how this is diagnosed. Do they go to their primary care physician? Do they go to the emergency room? Talk a little bit about that.
Dr. Klodell: Yeah, I think first and foremost, the primary care physicians are the lifeblood of our healthcare system and everybody should have a reliable good physician that they feel confident in and they see them frequently kind of for their well checks but also, it’s their first line of defense when they feel like something maybe isn’t quite right. Many of those physicians have a long track record of seeing and listening to those particular patients and I say seeing and listening because when they put their stethoscope on that patient’s chest, they are going to say wow, I hear something I hadn’t heard before. They are going to hear a new murmur. Which is when that valve that is either leaking or not opening properly creates turbulence in the flow of the blood and that’s what we actually hear in our stethoscope is that turbulent flow.
Most often then the primary care doctor is going to order an echocardiogram which is an ultrasound intended to let us look at those valves a little better and see what the velocities across them are doing. And then if appropriate, they will send that patient either to a cardiologist or to a cardiothoracic surgeon or whatever. Now other patients may already have been seeing a cardiologist. Oftentimes, particularly in older patients, they will have atrial fibrillation or something like that and they are chronically followed by a cardiologist and if that’s the case; then certainly they could see their cardiologist directly and get an echocardiogram and see what’s going on.
Host: Okay so if there are issues with a heart valve, what are some of the treatment options available to patients?
Dr. Klodell: Well 2019 is a great time because we have so many options available to us now. As time has progressed, and we’ve acquired more and more technology; now there are both open surgical, minimally invasive and then even catheter-based solutions for almost every valvular problem in the heart. And our goal is really to look at every patient’s problem and say what is the least invasive, least injurious way that we can resolve this patient’s problem and get them back to the highest functioning quality of life. It’s about not only the length of life we’re going to extend them but also the quality of life that we can provide them and how rapidly we can provide it with the least amount of disruption to their daily activities.
Host: I really love that philosophy and it sounds like it’s an extremely high level of care. But I want to talk about prevention for a second. What can people do to avoid a lot of these heart valve issues that we’re talking about?
Dr. Klodell: Well so some of the developing heart valve issue is just in your genetics. It’s in your DNA. There’s not much you can do about that. They always say you can pick your friends, but you can’t pick your parents. So, the genes you have is the genes that you have. Now, having said that, there are somethings for example, if you have calcium forming on your valves and things there may be some medicines that your doctor has put you on to reduce the rate of calcification. If you have high blood pressure, controlling the blood pressure can help slow the deterioration of the valves.
So, we can’t stop the genetics that someone got but maybe we can get the most mileage out of them that’s possible.
Host: Yeah, it is pretty amazing the number of treatment options available to patients in 2019. And I know that even some of them will have patients walking out the very next day. Is that correct?
Dr. Klodell: Absolutely. With the new technology some of which we have that’s commercially available, some of which we are very fortunate to be a trial enter for some of the FDA sponsored research of new devices coming into the country allows us to treat people with what I term the absolute cutting edge technology and match the right treatment to the right patient. And so, as you say, many times these patients are only in the hospital overnight and are back to full function within a couple of days. Which is just amazing compared to what we were doing ten or fifteen years ago.
Host: All right Dr. Klodell. I really appreciate your time today. That’s Dr. Charles Klodell, a cardiothoracic surgeon at North Florida Regional Medical Center. Thanks for checking out this episode of Helmet of Health. Head to FLHeartAndLung.com to get connected with a provider. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.