Structural Heart Diseases

Structural heart diseases (SHD) refer to a group of heart conditions involving the valves, walls, chambers, or blood vessels of the heart. These conditions can be congenital (present at birth) or acquired (develop over time due to aging, infections, or other diseases). Understanding these diseases is crucial for early diagnosis and effective treatment.

Types of Structural Heart Diseases

Valvular Heart Diseases

Aortic Stenosis – Narrowing of the aortic valve, reducing blood flow from the heart.
Mitral Regurgitation – The mitral valve leaks, causing blood to flow backward into the heart.
Tricuspid Valve Disease – Dysfunction of the tricuspid valve, affecting right heart function.

Congenital Heart Defects

Atrial Septal Defect (ASD) – An opening between the two upper chambers of the heart.
Ventricular Septal Defect (VSD) – A defect between the heart’s lower chambers.
Tetralogy of Fallot – A combination of four congenital heart defects that affect normal blood flow.

Cardiomyopathies

Hypertrophic Cardiomyopathy (HCM) – Abnormal thickening of the heart muscle, affecting its ability to pump blood.
Dilated Cardiomyopathy (DCM) – Enlargement of the heart chambers leading to weakened pumping function.
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) – A condition affecting the right side of the heart, leading to abnormal heart rhythms.

Aneurysms and Other Structural Defects

Aortic Aneurysm – Weakening and bulging of the aorta, which can lead to life-threatening rupture.
Patent Foramen Ovale (PFO) – A small hole in the heart that fails to close after birth.

Hypertension and Atherosclerosis

High blood pressure and cholesterol build-up can lead to structural changes.

Age-related changes

Over time, the heart valves may develop calcifications.

Infections and Inflammation

Conditions like rheumatic fever or endocarditis can damage heart valves.

Congenital abnormalities

Some SHDs are genetic and present at birth.

Symptoms

Shortness of breath

Chest pain or discomfort

Fatigue and weakness

Irregular heartbeat (arrhythmia)

Swelling in the legs or abdomen

Diagnosis

Echocardiogram:

Uses ultrasound to assess heart structure and function.

Cardiac MRI and CT:

Advanced imaging techniques for detailed visualization.

Electrocardiogram (ECG):

Records the heart’s electrical activity.

Cardiac Catheterization:

A procedure to evaluate blood flow and pressure inside the heart.

Medications:

Beta-blockers, diuretics, anticoagulants, etc., to control symptoms.

Interventional Procedures:

Valve repairs, stent placements, and other catheter-based interventions.

Surgery:

Valve replacement, septal defect repair, or aneurysm repair if necessary.

Lifestyle Changes:

Maintaining a heart-healthy diet, exercise, and smoking cessation.

Conclusion

Structural heart diseases require careful diagnosis and tailored treatment to improve the patient’s quality of life and prevent severe complications. Early detection and management are crucial to ensuring better outcomes.

Information resources recommended

1. American College of Cardiology/American Heart Association Guidelines for the Management of Patients With Valvular Heart Disease

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923

https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/03/13/18/13/2024-acc-aha-clinical-performance-valvular

https://pubmed.ncbi.nlm.nih.gov/9809971/

https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/12/16/21/58/2020-ACC-AHA-VHD-GL-Pt-1-GL-VHD

https://pubmed.ncbi.nlm.nih.gov/33332149/

2. European Society of Cardiology Guidelines on Valvular Heart Disease

https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines

https://academic.oup.com/eurheartj/article/43/7/561/6358470

https://pubmed.ncbi.nlm.nih.gov/34453165/

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923

https://pubmed.ncbi.nlm.nih.gov/17259184/

3. American College of Cardiology Foundation/American Heart Association Guidelines for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000937

https://pubmed.ncbi.nlm.nih.gov/22075469/

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001250

https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/11/18/18/47/2020-AHA-ACC-Guideline-for-HCM-GL-HCM

https://www.sciencedirect.com/science/article/pii/S0735109720364123

4. European Society of Cardiology Guidelines on Adult Congenital Heart Disease

https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Grown-Up-Congenital-Heart-Disease-Management-of

https://academic.oup.com/eurheartj/article/42/6/563/5898606

https://pubmed.ncbi.nlm.nih.gov/32860028/

https://www.jacc.org/doi/10.1016/j.jacc.2021.09.010

https://pubmed.ncbi.nlm.nih.gov/34736567/

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Diagnoses

Symptoms