Valvular Heart Disease: Clinical Patient Journey

Valvular heart disease occurs when one or more of the heart’s four valves don’t open or close properly, disrupting blood flow and placing extra strain on the heart muscle. The most common valve disorders include aortic stenosis, mitral regurgitation, and mitral valve prolapse.

Thanks to advances in imaging and minimally invasive procedures, most patients can now receive effective, low-risk treatment before serious complications develop, making early detection essential.

At The Medical Group of New Jersey, echocardiography identifies the affected valve, and treatment ranges from medical symptom control to minimally invasive or surgical valve repair or replacement, restoring healthy blood flow through the heart.

Symptom Onset & Initial Evaluation

Valve disease often progresses gradually. Many people don’t notice symptoms until the condition becomes moderate or severe. Common warning signs include:

• Shortness of breath or fatigue, especially during physical activity
• Chest discomfort or heart palpitations
• Swelling in the legs or ankles
• Lightheadedness or fainting (particularly in aortic stenosis)
• Sometimes, a heart murmur detected during a routine exam is the first clue.

Initial testing may include:

• Echocardiogram (ECHO): The key test to assess valve anatomy and blood flow.
• Electrocardiogram (ECG): Detects irregular heart rhythms or chamber enlargement.
• Chest X-ray or Cardiac MRI: Evaluates heart size and structure.
• Cardiac Catheterization: Measures heart pressures and oxygen flow before surgery or valve intervention.

Diagnosis & Classification

Valvular disease is categorized by how the valve is affected:

• Stenosis: The valve is too narrow, restricting blood flow.
• Regurgitation (Insufficiency): The valve doesn’t close completely, allowing blood to leak backward.
• Mixed Disease: Both narrowing and leakage occur in the same valve.

Common valve disorders include:

• Aortic stenosis or regurgitation
• Mitral regurgitation or prolapse
• Tricuspid or pulmonary valve disease

Your cardiologist will determine the severity (mild, moderate, or severe) and discuss whether medical management or a procedure is appropriate.

Treatment & Management

Treatment depends on the type of valve disease, its severity, and your overall heart function.

Medical Therapy (for Early or Moderate Disease)

• ACE inhibitors or beta-blockers: Help control blood pressure and reduce heart strain.
• Diuretics: Reduce fluid buildup and ease congestion.
• Heart rhythm management: For atrial fibrillation or other arrhythmias.
• Antibiotic prophylaxis: May be recommended before dental work to prevent infection (endocarditis) in certain patients.

Procedural & Surgical Options

For more advanced disease, interventional or surgical repair may be needed:

• Transcatheter procedures (TAVR, MitraClip®): Minimally invasive valve repair or replacement for patients at higher surgical risk.
• Traditional valve surgery: Open-heart valve repair or replacement for durable, long-term correction.
• Balloon valvuloplasty: A catheter-based option for younger patients with certain valve narrowings.

Your cardiac care team will recommend the best treatment based on your age, symptoms, and imaging results.

Long-Term Monitoring & Prevention

Even after successful treatment, regular follow-up care is essential to protect your heart health.

• Echocardiograms every 6 to 12 months (or sooner if symptoms change)
• Heart-healthy lifestyle: Balanced diet, regular exercise, and blood pressure control
• Monitoring for arrhythmias or heart failure
• Good dental hygiene to reduce infection risk (endocarditis prevention)

At The Medical Group of New Jersey, our structural heart specialists work closely with cardiothoracic surgeons and imaging experts to provide seamless, multidisciplinary care, from early diagnosis through full recovery.