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What Is Structural Heart Disease?

Your heart is similar to a sophisticated building. While the rooms and passageways of a building provide safety for its occupants, those within your heart keep your blood flowing in and out properly — all in order to ensure your health and well-being.

Also like a building, structural problems can lead to issues down the road, especially if they're not properly treated and cared for.

Muhammad Raza, MD, FACC

Muhammad Raza, MD, FACC
The Heart Valve Center at Chester County Hospital

"Structural heart disease is a form of heart disease that refers to defects within your heart that you were either born with or have developed due to aging, injury, or infection. Similar to other kinds of heart disease, it can lead to health problems if left untreated. However, unlike other types, it usually has nothing to do with eating, exercising, smoking, or other lifestyle choices," says Muhammad Raza, MD, interventional cardiologist at the Heart Valve Center and Director of the Penn Medicine Structural Heart Disease Program at Chester County Hospital.

There are many types of structural heart disease.

One of the most common forms of structural heart disease is valvular heart disease, which is when a heart valve is damaged or doesn't work properly. There are also other types, such as when a baby is born with a hole in their heart, called an atrial septal defect.

Structural Heart Disease by the Numbers graphic

The structure of your heart is elaborate, and abnormalities can be dangerous for your health. Here's what you should know about this essential organ — and what problems can occur.

Heart Basics: The Role and Structure of an Essential Organ

Structure of the Heart Image

The role of your heart is undeniably critical. By pumping blood throughout your body, your cells are able to get the blood, oxygen, and nutrients they need to survive.

"This vital organ is made up of two major components — chambers and valves. The chambers are like rooms within your heart, while the valves are similar to doors that separate those rooms," says Dr. Raza.

Heart Chambers

In a normal heart, there are two sides (right and left) and four chambers (upper and lower). The upper chambers, which are referred to as the right atrium and left atrium, collect blood that comes from the body or the lungs.

The lower chambers, which are called ventricles, receive blood from the atria and pump it out to the rest of the body. The right ventricle sends blood to the lungs, and the left ventricle sends blood to the rest of the body.

Heart Valves

"Both the direction and timing of how the blood is pumped are vital to the proper functioning of your heart, and this is where heart valves come in. In order to empty blood from each chamber and keep it moving forward, valves must close and open correctly and in the right order," says Dr. Raza.

Abnormalities within these chambers or valves can make it difficult for your heart to do its job effectively — and they may be a sign of structural heart disease.

Types of Structural Heart Disease

The complexity of the heart means there are a variety of possible types of structural heart disease. Here are some of the most common forms.

Heart Valve Disease

When your heart valves don't work properly, blood doesn't flow in and out of your heart as it should. Types of heart valve disease include:

  • Regurgitation, which is when blood leaks back through a valve in the wrong direction. One common leaky valve in the heart is Mitral valve prolapse/regurgitation, which is when the mitral valve (which separates the top left chamber from the bottom left chamber) doesn't close tightly enough.
  • Stenosis, which is when a valve doesn't open enough, blocking blood flow. The aortic valve, which is similar to the main door of a house and the last valve in the heart blood has to pass through to the body, is the most common to have stenosis leading to decreased blood flow to the entire body. This in turn leads to shortness of breath or chest discomfort.

You can be born with heart valve disease or it can be caused by infection, heart attack, heart disease, or heart damage. Some valve problems are minor and only require periodic surveillance with echocardiograms. However, more advanced valve disease is a mechanical problem and usually requires replacement or repair through minimally invasive procedures, such as transcatheter aortic valve replacement (TAVR).

"This procedure is performed under conscious sedation through a very small incision in the groin, and patients go home in 24 to 48 hours later with a new valve in the heart," adds Dr. Raza.

Congenital Heart Disease (Atrial Septal Defect)

As a baby develops during pregnancy, there are several openings between the chambers of the heart which, as the baby grows, close off. One of these openings divide the upper chambers of the heart and usually close towards the end of pregnancy or shortly after the baby is born.

Sometimes, this stays open, leaving a hole called an atrial septal defect. Though the cause is largely unknown, it may be due to genetics or food, drink, or medicine the mother ingests during pregnancy.

"Treatment for atrial septal defect depends on the size of the hole and severity of symptoms in adult life. It may require monitoring and medication to treat symptoms, or usually a minimally invasive transcatheter repair/closure or rarely surgery," Dr. Raza says.

The Importance of Caring for Your Heart

Your heart works hard to keep you healthy — and it's important to do everything you can in order to support it, including monitoring for potential problems.

However, because of its complex setup, signs of structural problems within your heart vary. For instance, heart valve disease might show up as chest pain, shortness of breath, and lightheadedness, syncope (loss of consciousness), or it might come with no symptoms at all.

While the structure of your heart may not be completely in your control, living a heart-healthy lifestyle is. Eating healthy, staying active, and not smoking all ensure your heart is as strong as it can be. That, along with maintaining routine medical check-ups, helps set your heart up for success — for now, and for many years down the road.

Do you have questions about structural heart disease? Call 610-738-2660 to speak with a clinician at The Heart Valve Center at Chester County Hospital.


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