Structural Heart Disease Specialty Unit

It occurs when the heart’s aortic valve narrows. This obstructs blood flow into the aorta and the rest of the body, causing the heart to work harder. Eventually, the heart muscle weakens and symptoms develop. If left untreated, aortic stenosis can lead to serious heart problems.

Mitral valve stenosis also called Mitral Stenosis is a narrowing of the heart’s mitral valve. This abnormal valve doesn’t open properly, blocking blood flow into the main pumping chamber of your heart (left ventricle). Mitral valve stenosis can make you tired and short of breath, among other associated problems.

A Bicuspid Aortic Valve is an aortic valve that has two flaps (cusps) instead of three. It may cause a narrowed aortic valve opening (aortic valve stenosis), making it difficult for the heart to pump blood into the body’s main artery (aorta), or it can cause valvular leakage, leading to an enlarged heart and weakened heart muscle over time.

Also known as a click-murmur syndrome, Barlow’s syndrome, balloon mitral valve, or floppy valve syndrome, is the bulging of one or both mitral valve flaps (leaflets) into the left atrium during the contraction of the heart.

Mitral valve regurgitation can occur due to mitral valve prolapse, mitral leaflet flail, or secondary to increased annular dimension or enlarged heart. Mitral valve regurgitation can make you tired and short of breath, among other problems.

Signs and symptoms may include one or more of the following:

• Chest discomfort (pain may get worse with activity)
• Cough (possibly bloody)
• Breathing problems when exercising
• Becoming easily tired
• Feeling the heartbeat
• Fainting
• Weakness or dizziness with activity

Procedures, Tests and Services provided: & tests include:

• Cardiac Catheterization
• CT scan
• Echocardiogram (TTE and TEE)
• Carotid Ultrasound
• Laboratory tests
• Physical Exam
• Frailty Testing
• Pulmonary Functional Testing
• Arterial Blood Gases
• Breathing Test
• Transcatheter or surgical valvular repair or replacement

PFO is an acquired structural abnormality. It is a small opening between the two upper chambers of the heart, the right, and the left atrium.

Most patients with a PFO do not have any symptoms. However, the condition may play a role in migraine headaches and it increases the risk of stroke, transient ischemic attack, and heart attack.

Associated procedures & tests include:

• Echocardiogram (echo)
• Transesophageal echo (TEE)
• Transcatheter device closure
• Bubble study: This is done during an echo or TEE. An IV filled with agitated saline is placed in your arm. The saline makes bubbles that the doctor watches to see if they move from one side of the heart to the other
• You may need other tests to check your heart rhythm, nervous system, and to test for conditions that increase your risk of blood clots (hypercoagulable state)

An atrial septal defect (ASD) is a hole in the wall (septum) between the two upper chambers of your heart (atria). The condition is present at birth (congenital).

Small defects might be found by chance and never cause a problem. Some small atrial septal defects close during infancy or early childhood. Larger defects can lead to enlargement and increased pressure in the right-sided chambers of the heart. Larger defects need to be closed before the irreversible rise in pulmonary pressure occurs.

Signs and symptoms may include one or more of the following:

• Shortness of breath, especially when exercising
• Fatigue
• Swelling of legs, feet, or abdomen
• Heart palpitations or skipped beats
• Stroke
• Heart murmur, a whooshing sound that can be heard through a stethoscope

Associated procedures & tests include:

• Cardiac catheterization
• Echocardiogram
• Electrocardiogram (ECG or EKG)
• Minimally invasive heart surgery
• MRI
• X-ray
• Transcatheter device closure or surgical closure

VSD is a birth defect of the heart in which there is a hole in the wall (septum) that separates the two lower chambers (ventricles) of the heart. Small defects usually are asymptomatic and can be left. Larger defects might lead to the left chamber of the heart being enlarged and therefore might require closure.

Associated procedures & tests include:

• Cardiac catheterization
• Chest X-rays
• Echocardiogram
• Electrocardiogram (ECG or EKG)
• Transcatheter device or surgical closure

HCM is a disease in which the heart muscle becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood.

Signs and symptoms may include one or more of the following:

• Chest pain, especially during exercise
• Fainting, especially during or just after exercise or exertion
• Heart murmur, which a doctor might detect while listening to your heart
• The sensation of rapid, fluttering, or pounding heartbeats (palpitations)
• Shortness of breath, especially during exercise

Associated procedures & tests include:

• Ablation therapy
• Cardiac catheterization
• Echocardiogram
• Electrocardiogram (ECG or EKG)
• Genetic testing
• Holter monitor
• Implantable cardioverter-defibrillators (ICDs)
• MRI
• Pacemaker