Structural Heart Disease

Structural heart disease encompasses a range of conditions that affect the heart's anatomy, including its chambers, valves, and walls.

Unlike coronary artery disease, which involves the blood vessels, structural heart disease involves defects or abnormalities that can be congenital or acquired.

These abnormalities can disrupt the normal flow of blood through the heart, leading to various complications.

Types of Structural Heart Disease

Congenital Structural Heart Disease

Congenital structural heart disease is present at birth and includes conditions such as atrial septal defects (ASDs), ventricular septal defects (VSDs), and congenital valve abnormalities. These conditions often require early diagnosis and intervention to prevent long-term complications.

Acquired Structural Heart Disease

Acquired structural heart diseases develop later in life and can result from infections, ageing, or other medical conditions. Examples include mitral valve prolapse, aortic stenosis, and hypertrophic cardiomyopathy.

Valvular Heart Disease

Valvular heart disease involves damage to one or more of the heart's valves. This can lead to conditions like mitral valve regurgitation, aortic valve stenosis, and tricuspid valve stenosis, each requiring specific diagnostic and treatment approaches.

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Structural Heart Disease Causes

The causes of structural heart disease vary widely and can be congenital or acquired. Congenital causes often involve genetic factors or issues during fetal development. Acquired causes can include:

Infections: Rheumatic fever and infective endocarditis can damage heart valves.
Degenerative Changes: Aging can lead to calcification and degeneration of heart valves.
Trauma: Physical injury can affect the heart's structure.
Medical Conditions: Hypertension, diabetes, and other chronic conditions can contribute to structural heart disease.

Structural Heart Disease Symptoms

The symptoms of structural heart disease can vary depending on the specific condition and its severity. Common symptoms include:

Shortness of Breath: Difficulty breathing during exertion or at rest.
Chest Pain: Discomfort or pain in the chest, often exacerbated by physical activity.
Fatigue: Unusual tiredness and lack of energy.
Palpitations: Irregular or rapid heartbeats.
Swelling: Edema in the legs, ankles, and feet due to poor circulation.
Syncope: Episodes of fainting or dizziness.

Structural Heart Disease Diagnosis

Diagnosing structural heart disease involves a combination of clinical evaluation, imaging studies, and specialized tests. Essential diagnostic tools include:

Echocardiography

Echocardiography uses ultrasound waves to create detailed images of the heart's structure and function. It is a primary tool for diagnosing structural abnormalities and assessing their severity.

Electrocardiogram (ECG)

An ECG records the heart's electrical activity and can detect arrhythmias, ischemia, and other abnormalities that may be associated with structural heart disease.

Cardiac MRI

Cardiac magnetic resonance imaging (MRI) provides high-resolution images of the heart's anatomy and can identify structural abnormalities that may not be visible on echocardiography.

Cardiac Catheterization

Cardiac catheterization involves inserting a catheter into the heart's chambers to measure pressures and obtain detailed images of the heart's structure. It is often used to assess the severity of valvular heart disease and other structural abnormalities.

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Structural Heart Disease Treatment Options

Treatment for structural heart disease depends on the specific condition, its severity, and the patient's overall health. Options range from medical management to surgical interventions.

Medical Management

Medical management involves the use of medications to control symptoms and prevent complications. Commonly used drugs include:

Diuretics: To reduce fluid buildup and relieve symptoms of heart failure.
Beta-blockers: To manage arrhythmias and reduce the heart's workload.
ACE Inhibitors: To lower blood pressure and improve heart function.
Anticoagulants: To prevent blood clots in patients with certain types of structural heart disease.

Surgical Interventions

Surgical interventions are often necessary for severe cases of structural heart disease. These procedures aim to repair or replace damaged structures and restore normal heart function.

Valve Repair or Replacement

Valve repair involves surgically correcting a damaged valve, while valve replacement consists of replacing a damaged valve with a mechanical or biological prosthesis. These procedures are commonly performed for conditions like aortic stenosis and mitral regurgitation.

Septal Defect Repair

Septal defect repair involves closing holes in the heart's septum, such as atrial septal defects (ASDs) and ventricular septal defects (VSDs). This can be done surgically or using catheter-based techniques.

Left Atrial Appendage Occlusion

Left atrial appendage occlusion is a procedure used to reduce the risk of stroke in patients with atrial fibrillation. It involves closing off a small pouch in the left atrium where blood clots can form.

Advances in Structural Heart Disease Treatment

Recent advances in medical technology have significantly improved the treatment of structural heart disease. Minimally invasive procedures, such as transcatheter aortic valve replacement (TAVR) and MitraClip, have revolutionized the management of valvular heart disease, offering alternatives to traditional open-heart surgery.

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