Structural Heart Disease
Structural heart disease covers problems with the heart's valves, walls, and chambers - and many cases go undiagnosed until they cause symptoms. At MVM, we identify structural problems early and coordinate the right team when intervention is needed.
What is structural heart disease?
Structural heart disease refers to problems with the physical components of the heart - its four valves, the walls between chambers, and the chambers themselves. It is distinct from coronary artery disease (which affects the heart's blood supply) and arrhythmia (which affects the heart's electrical system).
The most common forms involve the heart valves: aortic stenosis (a stiff, narrowed aortic valve), mitral regurgitation (a leaky mitral valve), and similar problems with the tricuspid and pulmonary valves. Other structural conditions include holes between chambers (such as patent foramen ovale or atrial septal defect) and abnormalities of the heart muscle itself.
Structural heart disease often progresses slowly. Many patients are diagnosed by a murmur on routine exam or an incidental finding on an echocardiogram. Early diagnosis and careful follow-up are critical - modern catheter-based options like TAVR and MitraClip have changed what's possible, even for patients once considered too high-risk for surgery.
How MVM treats structural heart disease.
Patients and referring physicians choose MVM for structural heart concerns because we know when watchful waiting is the right answer - and when it's time to escalate.
- Same-week consults. New structural heart patients are typically seen within 5 business days. Significant valve disease or new murmurs are triaged faster.
- In-office echocardiography. Valve function and chamber size assessed at the first visit - no separate imaging appointment.
- Surveillance program. For valve disease not yet ready for intervention, structured follow-up imaging keeps you ahead of progression.
- Coordinated structural intervention. When TAVR, MitraClip, or surgical valve repair is the right call, we coordinate referral to a high-volume structural team and stay involved in your care.
- Second-opinion friendly. If you've been told you need valve surgery, we welcome the chance to review the imaging and confirm timing.
- One specialist, full continuum. The doctor who diagnoses you also manages your medications and follow-up.
Schedule a structural heart consultation.
Most patients are seen within a week. Bring any prior echocardiograms or cardiac imaging, your medication list, and a written summary of your symptoms.
Schedule a consultationSend us a structural heart referral.
Same-week consults for new murmurs, abnormal echocardiograms, or progressing valve disease. Closed-loop reporting back to your office within 48 hours.
Referral processCommon symptoms.
Symptoms depend on which valve or structure is affected. Many patients are asymptomatic for years before the heart starts to struggle.
- Shortness of breath, especially with activity or when lying flat
- Chest pressure or tightness
- Fatigue and reduced exercise tolerance
- Lightheadedness or fainting, especially with exertion
- Palpitations or irregular heartbeats
- Swelling in the legs, ankles, or abdomen
- A heart murmur heard during a routine exam
- Reduced ability to do activities you previously tolerated
Who is most at risk.
- Age - degenerative valve disease becomes much more common after 65
- History of rheumatic fever in childhood
- Congenital heart conditions, including bicuspid aortic valve
- Prior endocarditis (infection of a heart valve)
- Long-standing high blood pressure
- Coronary artery disease or prior heart attack
- Chest radiation for prior cancer treatment
- Family history of structural heart disease
How we diagnose structural heart disease at MVM.
Most patients leave their first visit with a clear diagnosis - and a plan.
- Focused history and exam - including careful listening for murmurs
- EKG - performed in our office at the first visit
- Transthoracic echocardiogram - the primary tool for assessing valve function and chamber size
- Transesophageal echocardiogram (TEE) - when more detailed valve imaging is needed
- Cardiac MRI or CT - for complex anatomy or pre-procedural planning
- Stress echo - to assess valve function under workload
Treatment options.
Many patients with mild or moderate structural heart disease are managed with surveillance and medical therapy for years. When intervention is needed, modern catheter-based options have transformed what's possible.
Surveillance and medical management
For mild to moderate valve disease, the right answer is often careful watching. We use periodic echocardiograms to track progression, manage blood pressure and heart failure when they coexist, and reassess timing of any intervention. Endocarditis prevention is reviewed for selected high-risk patients.
Catheter-based and surgical procedures
When valve disease becomes severe or starts affecting heart function, intervention options include:
- TAVR (transcatheter aortic valve replacement) - replaces a stenotic aortic valve through a small access point, not open surgery
- MitraClip and other transcatheter mitral repair - for selected patients with significant mitral regurgitation
- Surgical valve repair or replacement - when surgery offers the best long-term result
- Closure devices - for atrial septal defects, patent foramen ovale, and left atrial appendage occlusion
We coordinate these procedures with high-volume structural heart teams and stay involved in your pre- and post-procedural care.
Recovery and ongoing care
Recovery from catheter-based valve procedures is often days, not weeks - most patients are home within a day or two and back to light activity within a week. Surgical recovery is longer. Either way, we see you closely in the months after the procedure and coordinate with your primary care physician for long-term follow-up.
When to see a cardiologist.
- A heart murmur found on routine exam
- An abnormal echocardiogram showing valve or chamber issues
- New or worsening shortness of breath with activity
- Lightheadedness or fainting with exertion
- A recommendation for valve surgery or TAVR - second opinions welcome
If you have severe shortness of breath, crushing chest pain, or you faint with no warning - call 911 or go to the nearest emergency room. Severe valve disease can present as a cardiac emergency.
Structural heart FAQs.
Does a heart murmur always mean structural disease?
No. Many murmurs are benign - particularly “innocent” flow murmurs in younger people. But any new or unfamiliar murmur deserves an echocardiogram to confirm whether the valves and chambers are normal.
What is TAVR, and how is it different from open surgery?
TAVR (transcatheter aortic valve replacement) places a new aortic valve through a small access point, usually in the groin - without opening the chest. Recovery is much faster than open surgery, and TAVR is now an option for many patients who would have once been told they were too high-risk for any intervention.
How often does my valve need to be checked?
It depends on severity. Mild disease may need an echo every 3–5 years; moderate disease, every 1–2 years; severe disease, every 6–12 months - or sooner if symptoms change. We set the schedule with you at the first visit.
Can valve disease be treated with medication alone?
Medications can manage symptoms and treat coexisting conditions, but they don't reverse the structural problem itself. For severe valve disease, the definitive treatment is repair or replacement - either by catheter or surgery.
Should I get a second opinion before valve surgery?
Yes. Timing of valve intervention is one of the most consequential decisions in cardiology, and it's reasonable to confirm the recommendation with an independent specialist. We see second-opinion referrals quickly and will review the imaging directly.
Schedule a structural heart consultation.
Most new patients are seen within a week. Bring any prior echocardiograms or cardiac imaging, the medication list, and a written summary of your symptoms - we'll do the rest.