STRUCTURAL HEART DISEASE

Structural heart disease is a broad term for any issue with the structure of the heart. It means
there is an abnormality in the structure or function of the valves, walls, chambers or muscles
in the heart.
You can be born with structural heart disease (congenital) or it can develop as you age.
Structural heart disease can lead to other health problems over time if left untreated.
What are the types of structural heart disease?
The main types of structural heart disease are:
1. Heart valve disease, a problem with any of the four valves that open and close to control
blood flow, which include; Aortic valve disease, Mitral valve disease, Tricuspid and
Pulmonic valve disease
2. Cardiomyopathy, a disease involving the heart muscle (Hypertrophic cardiomyopathy).
3. Congenital heart disease, structural heart problems that you have at birth.
Who might get structural heart disease?
Structural heart disease can affect anyone no matter their gender, ethnicity or race.
Depending on the issue, it may be more common in people with a family history of structural
heart disease. **It may also be more common in children whose birth parent had:
-Exposure to industrial solvents during pregnancy.
-Rubella during their first trimester of pregnancy.
-Taken certain medications or drank alcohol during pregnancy.
-Viral infections during pregnancy.
**The risk of structural heart disease also increases as you get older. More than 10% of
adults over age 75 have structural heart disease.
How common is structural heart disease?
Heart valve disease is the most common type of structural heart disease. It affects about 2.5%
of all people in the United States. This includes valvular regurgitation (leaking) or stenosis
(narrowing). Mitral valve regurgitation is the most common valve disease in the United
States, though aortic valve stenosis is also very common. More than 2 million people in the
U.S. have a leaky heart valve.
In addition, about 1.4 million adults and 1 million children in the U.S. have a congenital heart
condition. Congenital heart conditions are the most common type of birth defect in the U.S.
They affect nearly 1% of births (about 40,000 babies) each year.
Lastly, as many as 1 in 500 people in the U.S. may have cardiomyopathy. There are many
reasons for cardiomyopathy, including coronary artery disease, consequences of viral
infection, environmental exposures (such as alcohol) and inherited causes.
How does structural heart disease affect the body?
Structural heart disease makes it more difficult for the heart to pump blood to the rest of the
body. Blood contains nutrients and oxygen that the body’s cells need to survive. It also
carries waste out of the cells.
You may damage the organs and other tissues if the heart isn’t able to pump enough blood to
the rest of the body. This can lead to many other health problems and symptoms.
Symptoms and Causes
What causes structural heart disease?
You can be born with structural heart disease. The heart may develop abnormally due to
problems with the body’s DNA or genetics.
Structural heart disease can also develop later in life due to:
Aging, which can cause calcium deposits on the heart valves.
Alcohol or drug addiction.
Aortic aneurysm.
Autoimmune disease, such as lupus and rheumatic fever.
Cardiovascular disease or heart attack (myocardial infarction).
Diseases that damage the heart, such as amyloidosis, hemochromatosis or sarcoidosis.
Endocarditis.
Endocrine diseases, such as diabetes and thyroid disease.
High blood pressure (hypertension).
High-dose radiation exposure.
Marfan syndrome.
Muscle conditions, such as muscular dystrophy.
Plaque buildup in arteries (atherosclerosis).
What are the symptoms of structural heart disease?
You can have structural heart disease and not have any signs or symptoms. As the disease
progresses, symptoms may include:
Chest pain, tightness or pressure.
Dizziness, lightheadedness or fainting (syncope).
Fatigue.
High blood pressure (hypertension).
Irregular heartbeats (arrhythmia).
Kidney dysfunction.
Shortness of breath (dyspnea).
Swelling in the abdomen, ankles or feet (edema).
Diagnosis and Tests
-During pregnancy, the healthcare provider may use a fetal echocardiogram to detect
structural heart disease. They can do this at or before birth.
-Auscultation
-Cardiac catheterization: During cardiac catheterization, the cardiologist inserts a small tube
through an artery in the groin. Then, they thread it to the heart. The cardiologist tests
pressures within the heart chambers. And, they may look at close-up images of the heart and
blood vessels.
-Coronary angiogram: The cardiologist will use cardiac catheterization to
perform angiography. They inject dye through the catheter into the blood vessels. The
cardiologist uses an X-ray to view blood flow through the heart, arteries and valves.
-Echocardiogram: Echocardiogram (also called an echo) uses soundwaves to create images of
the heart’s chambers and valves. This test examines the heart’s pumping action.
-Electrocardiogram: An electrocardiogram (also called an ECG or EKG) measures the
electrical activity of the heart.
-Exercise stress test: During anexercise stress test, you walk or run on a treadmill. While you
exercise, the provider monitors the heart.
-Holter monitor: A Holter monitor records the heart’s electrical activity for 24 to 48 hours
while you perform the daily activities.
Imaging tests: A chest X-ray, CT scan or cardiac MRI takes pictures inside the chest to look
for structural problems.
ECG and echocardiogram are the most common tests done to evaluate for structural heart
disease.
Management and Treatment
Some types of structural heart disease won’t need treatment, however, there will be need to
monitor the condition throughout the lifetime.
The provider may treat other types of structural heart disease with:
Medications.
Minimally invasive heart procedures, which use only small incisions to repair or replace a
defective valve.
Open-heart surgery, where a surgeon opens the chest wall to access the heart for valve
replacements or a heart transplant.