Download The Valve Clinic

The Valve Clinic
at Baptist Health Madisonville
The Valve Clinic
at Baptist Health Madisonville
Welcome to the Baptist Health Madisonville Valve Clinic
at the Jack L. Hamman Heart & Vascular Center. We
are committed to bringing a collaborative approach for
diagnosing, managing, and treating heart valve disease.
Our heart and valve program offers the skills and
experience of board-certified cardiovascular physicians,
nurse practitioners, and other healthcare professionals.
Your initial visit will include diagnostic testing with sameday results, a comprehensive physical assessment with
our Cardiovascular Nurse Practitioner, and a detailed
discussion with our Cardiologist and Cardiovascular
Surgeon regarding treatment options and management.
If surgical intervention is an option for you, we offer
conventional, minimally invasive, and catheter-based
technologies for your valve repair or replacement.
The best approach for you will be discussed
in detail with your surgeon.
If your heart valve disease is non-surgical, a detailed
medical management plan will be established with
6-month monitoring of your heart valve with an
echocardiogram and physical assessment.
Our Collaborative Heart Valve Team
Back row left to right: Georganna Ellis, RDCS; Dr. Wayne Lipson, MD;
Dr. T. Mark Stanfield; Dr. Getu Assefa, MD; and Bruce Gaston, RDCS.
Front row: Erin Larkins, APRN, ACNP-BC; and Cheri Edelen, APRN,
ACNP-BC. Not pictured here: Katie Drury, KCSA; Sherry Winn, KCSA;
Rachel Spears, Medical Assistant and Donna Oldham, Medical Assistant.
Inside Your Heart
The heart contains four chambers.
The heart pumps blood by
contracting (squeezing blood out of
its chambers) and relaxing (allowing
blood to enter its chambers). The
two upper chambers are called the
atria. They receive blood returning
from the body through veins. The
two atria contract with only a small
amount of force, sending the blood
to the ventricles; the ventricles are
the muscular, lower chambers of
the heart. The ventricles contract
with greater force, delivering blood to the body by your arteries.
The right ventricle pumps blood to the lungs. Of all the chambers
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in the heart, the left ventricle does the greatest amount of work.
Powerful contraction of the left ventricle sends oxygen-rich blood
to all of the body’s organs.
Human heart valves are tissue-paper thin membranes attached
to the heart wall opening and closing with each heart beat. There
are four cardiac valves. Their purpose is to ensure that blood flows
only in one direction. The heart’s valves open at the appropriate
times to allow forward flow of blood, but close to prevent backflow of blood. The mitral and tricuspid valves control the flow of
blood from the atria to the ventricles. The aortic and pulmonary
valves control the flow of the blood out of the ventricles. The
characteristic heart sound (“lub, dub”) are caused by the closing
of the heart valves — the first by closure of the mitral and tricuspid
valves and the second by closure of the aortic and pulmonary
valves.
Heart Valve Problems
Heart valves can have three basic kinds of problems —
regurgitation, stenosis, and atresia. Regurgitation, or backflow,
occurs if a valve doesn’t close tightly. Blood leaks back into the
chambers rather than flowing forward through the heart or into an
artery. Stenosis occurs if the flaps of the valve thicken, stiffen, or
fuse together. This prevents the heart valve from fully opening. As
a result, not enough blood flows through the valve. Some valves
can have both stenosis (poor opening) and backflow problems.
Congenital heart valve disease develops before birth. This often
involves the pulmonary or aortic valves not forming properly.
Acquired heart valve disease usually involves aortic or mitral valves
that have developed disease over time.
Causes of Heart Valve Disease
Heart conditions and other disorders, age-related changes,
rheumatic fever, or infections can cause acquired heart valve
disease. Certain conditions that can stretch and distort the heart
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The Valve Clinic at Baptist Health Madisonville
Illustration Copyright © 2013 Nucleus Medical Media, All rights reserved. www.nucleusinc.com
valves include damage and scar tissue due to a heart attack or
other injury to the heart, advanced high blood pressure and heart
failure, as well as atherosclerosis (plaque build’s up) in the aorta
and valve. Age-related changes of men older than 65 and women
older than 75 are prone to developing calcium in their heart valves.
This stiffens and thickens the valve flaps and limits blood flow
through the valve (stenosis). The aortic valve is especially prone to
this problem.
Rheumatic fever most commonly from an untreated strep infection
can cause damage or scarring of the heart valves. The aortic and
mitral valves most often are affected. Today’s early treatment of
strep infections with antibiotics has decreased rheumatic valve
disease in America. A rare but serious infection called infective
endocarditis can develop in people who already have abnormal
blood flow through a heart valve. Common germs that enter the
bloodstream and get carried to the heart can infect the inner
surface including the heart valves. Germs enter the bloodstream
through needles, syringes, and breaks in the skin, and dental
procedures.
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Signs and Symptoms
of Heart Valve Disease
The main sign of heart valve disease is a heart sound called a heart
murmur. This can be detected by your doctor with a stethoscope.
Some heart murmurs are present without heart disease. If you have
a murmur further testing is required to determine the presence of
valve disease. Other common signs and symptoms include: unusual
fatigue, shortness of breath, swelling in your ankles, feet, legs,
abdomen, and neck veins. You may experience chest pain with
exertion that may be associated with fluttering, racing of the heart,
irregular heartbeat, dizziness, or fainting.
Diagnostic Tests For
Heart Valve Disease
Echocardiography is the main test for diagnosing heart valve
disease. Sound waves create a moving picture of your heart as
it beats using a transducer on the surface of your chest. An
echocardiogram can show the size and shape of your heart valves
and chambers, how well your heart is pumping blood, and whether
a valve is narrow or has backflow. This test is interpreted by a
cardiologist.
Another test that may be recommended depending on the results
of your echocardiogram is a transesophageal echocardiogram
(TEE) to get a better image of your heart. During a TEE, the
transducer is attached to the end of a flexible tube that travels
down your esophagus allowing a more detailed picture of your
heart. Relaxation medication is given during this procedure.
Additional tests to determine the severity of your heart valve
disease include: cardiac catheterization, stress testing, EKG, chest
x-rays, and CT scan.
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The Valve Clinic at Baptist Health Madisonville
Treating Heart Valve Disease
The goals of treating heart valve disease include preventing,
treating, and relieving the symptoms of other related heart
conditions, protecting heart valves from further damage, repairing
or replacing faulty valves when symptoms become severe or life
threatening.
Recommendations may include preventing, treating, or relieving
symptoms. Smoking cessation and following a healthy diet low
in sodium, added sugar, and fat are important. Medications may
be prescribed to lower your blood pressure and cholesterol,
reduce your heart’s workload thereby relieving symptoms, prevent
arrhythmias (irregular heartbeats), and thin your blood preventing
clots.
It is important to protect your heart valves if you’ve had previous
valve surgery or known valve disease. This includes flossing and
brushing your teeth daily, and scheduling regular visits with your
dentist. Gum infections and tooth decay can increase your risk
of infective endocarditis. Your doctor and dentist may give you
antibiotics before dental procedures that could allow bacteria to
enter your bloodstream.
Repairing or replacing your heart valve may be warranted to
prevent lasting damage to your heart and sudden death. Having
heart valve repair or replacement depends on the severity of your
valve disease, your age and general health, and whether you need
bypass surgery in addition to your valve surgery.
The Valve Clinic at Baptist Health Madisonville offers a
comprehensive approach including same-day diagnosis. We will
guide you from the initial evaluation through the final treatment
plan. The goal is to minimize your stress and answer your questions
while establishing a diagnosis and development of a treatment
plan. This approach provides easy access and continuous
feedback to the referring physician while offering coordinated and
personalized care to you, the patient.
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270.326.3800 l 866.606.7407
800 Hospital Drive l Madisonville, KY
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