LIVEWELL: Structural heart disease: Causes, treatments



Structural heart disease represents heart conditions that essentially disrupt the natural flow of blood through the heart. Structural heart disease can begin as a result of a birth defect, can develop later in life or can be a combination of both. Symptoms range from lightheadedness, fatigue, shortness of breath, chest pain and heart palpitations all the way to death.

At North Mississippi Medical Center’s Heart Institute, we have developed expertise in the diagnosis, treatment and management of these structural heart conditions – many through medical or minimally invasive methods. NMMC treats structural heart conditions including:

• Aortic stenosis – a narrowing of the valve between the heart and aorta that prevents it from opening properly. When this condition causes symptoms such as chest pain, shortness of breath, dizziness or fatigue, aortic stenosis can be treated by either traditional valve surgery, minimally invasive valve surgery (through a two-inch incision), and percutaneous aortic valve replacement (requiring no incision; done through groin access similar to a heart cath procedure). Percutaneous aortic valve replacement is also known as transcatheter aortic valve replacement (TAVR).

• Atrial septal defect/Patent foramen ovale – a hole between the heart’s two upper chambers. This finding may cause symptoms of shortness of breath, stroke, TIA, heart attack, or heart failure. Again when symptoms occur, this condition can be treated with either surgical or percutaneous closure (requiring no incision).

• Complex congenital heart disease – abnormalities in cardiovascular structures that occur before birth. Congenital heart defects may produce symptoms at birth, during childhood, not until adulthood or never. NMMC collaborates with the University of Mississippi Medical Center in Jackson to offer complex adult congenital heart surgery in Tupelo.

• Hypertrophic obstructive cardiomyopathy – abnormal thickening of the heart walls that is often associated with sudden death and is usually related to a genetic abnormality. NMMC offers genetic screening as well as percutaneous reduction of wall size through two different methods, and surgical resection.

• Mitral regurgitation – a weakening or stretching of the valve between the heart’s upper and lower left chambers that prevents it from closing properly. This condition can lead to shortness of breath, heart failure and abnormal heart beats. In addition to traditional and minimally invasive mitral valve surgery, NMMC will soon offer MitraClip, a percutaneous repair of the mitral valve requiring no incision.

• Valvular heart disease – conditions affecting all four valves within the heart. Treatment options include medications, pacemakers and surgery.

• Congestive heart failure – reduced pumping function of the heart. In addition to medication, pacemaker therapies and left ventricular reduction surgery, NMMC is the only hospital in north Mississippi that offers ventricular assist devices (VADs). Patients who are at risk of sudden cardiac death also have access to a variety of defibrillators – implantable, subcutaneous (placed just beneath the skin) and external/wearable.

• Atrial fibrillation that is highly symptomatic or has high potential for stroke – NMMC offers atrial fibrillation ablation for those patients with highly symptomatic atrial fibrillation. Patients who are at risk for stroke but can’t take blood thinners can opt for a left atrial appendage closure.

Many structural heart disorders progress slowly. What may seem like fatigue or a lack of energy can sometimes be a sign of something more serious, especially if you find yourself unable to be as active as usual. For more information about structural heart disease or available treatment, call 1-800-THE DESK (1-800-843-3375).

Dr. Barry Bertolet is an interventional cardiologist with Cardiology Associates of North Mississippi who serves on the medical staff of North Mississippi Medical Center’s Heart Institute.

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