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What Are Heart Valve and Structural Heart Disease?

Structural heart disease includes conditions that affect your heart’s chambers, muscles, walls or valves. Valvular (heart valve) disease, when your heart’s valves don’t open or close properly, is the most common type of structural heart disease. Some structural heart conditions are mild and don’t need treatment, while others require procedures or medications. A skilled heart care team can recommend the treatment that’s right for you.

Heart valve and structural heart disease care in the Puget Sound: Why choose us?

At Virginia Mason Franciscan Health, our structural heart team includes cardiologists, cardiac surgeons, interventional cardiologists and nurses. They have the expertise to diagnose and treat common and complex heart valve or structural heart conditions.

You can trust the quality of our care. Our program is nationally renowned for its excellence in heart disease treatment:

  • U.S. News & World Report ranked our program No. 1 for cardiac, heart and vascular surgery in Washington, Alaska, Montana, Idaho and Oregon for the 2023-2024 award period. 

  • The Society of Thoracic Surgeons awarded us a 3-star rating — the highest possible — for several heart procedures, including coronary artery bypass grafting (CABG), aortic valve replacement with CABG (AVR + CABG) and mitral valve repair and replacement (MVRR). Only programs that consistently provide the highest quality outcomes earn this distinction.

  • The Cardiac Care Outcomes Assessment Program awarded us a regional Performance Recognition Award for high-quality care and excellent outcomes.

Types of structural heart conditions

The main types of structural heart problems we treat include:

  • Your heart has four valves: aortic, mitral, pulmonic and tricuspid. These valves control blood flow in your heart by opening and closing. Heart valve disease occurs when one or more of your valves don’t open and close normally. Types of heart valve problems include:

    • Regurgitation: When your heart valves don’t close tightly, some blood can leak backward. Regurgitation usually occurs because of mitral valve prolapse (when the mitral valve cannot close tightly).
    • Stenosis: Sometimes, one of your heart valves is too narrow and doesn’t allow enough blood to flow through. Stenosis also occurs when the valve leaflets (flaps of tissue) thicken or fuse, preventing your valve from opening completely.

  • Congenital (present at birth) heart defects are structural heart problems that occur when your heart is developing before birth. These conditions can affect any part of the heart, including its valves, chambers and muscles. 

    A ventricular septal defect (VSD) is the most common type of congenital structural heart condition. Other examples include atrial septal defect, patent foramen ovale (PFO), patent ductus arteriosus and tetralogy of Fallot.

  • Cardiomyopathies are conditions that affect your heart muscle. Types of cardiomyopathy include:

    • Dilated cardiomyopathy (DCM): This condition occurs when one of your lower heart chambers (ventricles) is too large. Over time, DCM can decrease the amount of blood your heart can pump, leading to heart failure.
    • Hypertrophic cardiomyopathy (HCM): HCM is one of the most common types of inherited heart disease. This condition causes heart muscle to thicken and can lead to sudden cardiac arrest in adolescents and young adults. Learn more about our leading HCM program.
    • Arrhythmogenic cardiomyopathy (ACM): This type of cardiomyopathy causes your heart muscle to change into fatty and scar tissue. ACM can lead to an arrhythmia (irregular heart rhythm), heart failure and sudden cardiac death.
    • Restrictive cardiomyopathy: With restrictive cardiomyopathy, your heart’s ventricles become rigid and cannot relax between beats. This condition can cause arrhythmias and heart failure.

What does heart valve or structural heart disease feel like?

Early-stage or mild structural heart disease may not cause symptoms, but some people experience:

  • Chest pain
  • Dizziness or lightheadedness
  • Fatigue or weakness
  • Rapid heartbeat
  • Shortness of breath
  • Swelling in your feet and ankles

These symptoms can resemble a heart attack or another life-threatening emergency. Seek emergency medical care if you notice chest pain, shortness of breath or sudden dizziness.

What causes structural or valvular heart disease?

Structural heart and heart valve conditions can be congenital or acquired (develop over time). Some congenital heart conditions are passed down through families, but others occur without a family history. 

Common causes of acquired heart valve and structural heart conditions include:

  • Age: As we age, normal wear and tear on the heart can cause heart valves to stop working correctly.
  • Congenital heart valve conditions: If you are born with a valve defect, such as bicuspid aortic valve, you have a higher risk of developing another structural heart problem later.
  • Infections: Rheumatic disease (caused by strep infection) and endocarditis (infection of the heart’s inner lining) can cause scarring of the heart and structural heart problems.
  • Medical devices: Sometimes, implantable cardiac defibrillators (ICDs) and pacemakers can create scar tissue in the heart. 
  • Radiation treatment: Radiation therapy to the chest can thicken or narrow heart valves.

Heart valve and structural heart disease risk factors

Certain factors raise your risk of developing acquired heart disease, including:

  • Autoimmune conditions: Lupus and other autoimmune diseases may cause changes to your heart’s structure.
  • Genetics: Some types of acquired heart valve problems can run in families, including mitral valve prolapse and bicuspid aortic valve conditions.
  • Lifestyle habits: Lack of exercise, unhealthy eating habits, obesity and smoking increase your risk of developing structural or heart valve disease. Using intravenous drugs can also increase the chances that you’ll develop a structural problem with your heart.
  • Other types of heart disease: If you have a different kind of heart disease, such as heart failure or coronary artery disease (CAD), your risk of structural heart disease is higher.

Heart valve and structural heart disease diagnosis

Our specialists start with a complete assessment of your symptoms and health history. We perform tests to confirm a diagnosis if we suspect a possible heart condition. We usually recommend noninvasive tests such as an echocardiogram, electrocardiogram (EKG) or stress test. 

When needed, our team provides cardiac catheterization and nuclear cardiology tests for more detailed information about your heart. Learn about our diagnosis and testing methods for heart valve and structural heart disease.

Treatments for heart valve and structural heart disease

We provide comprehensive, personalized care for any type of heart valve or structural heart disease. Our team focuses on treatment that will optimize your heart health and improve your quality of life. We listen to your concerns and consider your preferences when we create your care plan.

  • Blood clots are a common complication of structural heart disease. Many people benefit from anticoagulation (blood thinner) medications to prevent clots. If you are taking blood thinners, it’s essential to receive ongoing care from a specialized heart team. Learn about how we care for people taking blood thinners in our anticoagulation clinics. 

    Our cardiologists may prescribe medications that relieve other symptoms, such as a fast heart rate. We monitor you closely to be sure the medication works for you.

  • Cardiac surgery is an effective treatment for many types of heart valve and structural problems. Our expert heart surgeons offer the full range of procedures for valve repair and replacement and congenital heart defects, including:

    • Minimally invasive cardiac surgery: We are one of only a few centers in the nation to perform minimally invasive heart surgery for mitral and tricuspid valve repair. These procedures have the same benefits as open-heart surgery without a large chest incision and a much faster recovery. Learn more about minimally invasive mitral and tricuspid valve surgery.
    • Mitral valve repair and replacement (MVRR): We perform a high volume of mitral valve repair and replacement surgeries. Ours is the only program in Washington state to earn a 3-star rating (the highest possible) for MVRR from the Society of Thoracic Surgeons. This distinction is a result of our skilled surgeons and consistently positive outcomes. 
    • Septal myectomy: We are among the most experienced in the nation at providing septal myectomy for HCM. Typically, only highly specialized HCM centers offer this procedure, which requires an expert cardiac surgery team. 
    • Tricuspid and aortic valve surgery: If minimally invasive techniques aren’t right for you, our cardiac surgeons offer open-heart surgery for tricuspid and aortic valve conditions. Our team ensures your safety and helps you through every step, from preparation to recovery and beyond.

  • Our interventional cardiologists often treat structural heart conditions with catheter-based procedures. 

    We perform these interventional procedures in our state-of-the-art hybrid operating room. This specialized treatment space combines advanced, real-time imaging with a traditional surgery suite. Evidence suggests that hybrid ORs result in shorter procedure times and improved patient outcomes. 

    We perform a high volume of interventional heart valve treatments, including: 

    • Transcatheter aortic valve replacement (TAVR) 
    • Transcatheter mitral valve replacement or repair (TMVR) 
    • Transcatheter tricuspid valve replacement or repair

    Our advanced methods are easier on your body than open-heart surgery, resulting in a shorter recovery, less pain and a lower risk of complications. Learn more about how we treat structural heart disease through our innovative interventional cardiology program.

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