What is structural heart disease?

Prof. Dr. med. Peter M. Wenaweser – Specialist in Cardiology and Internal Medicine – HerzKlinik Hirslanden

Structural heart disease refers to diseases of the heart that primarily affect one of the four heart valves, i.e. the Aortic, mitral, tricuspid and pulmonary valves. The most common structural heart diseases include aortic valve stenosis and mitral valve insufficiency. They usually occur in older people.

Aortic valve stenosis is a narrowing of the heart valve located in the aorta. The narrowing can be caused by inflammation or calcification. The result is an overload of the heart muscle because the heart has to pump faster. In mitral valve insufficiency, the heart valve does not close properly and is leaky. Structural heart disease can only be treated surgically.

What is the difference between a stenosis and an insufficiency?

Heart valves are functionally nothing more than a one-way valve. They regulate the blood flow in the heart in the right direction. As a blood pump, the heart can only conduct the blood flow correctly if the valves function normally. A heart valve can narrow for various reasons and obstruct the blood flow. This is referred to as valve stenosis. However, a heart valve can also become leaky so that the blood is pumped back through it. Then it is an insufficiency. There are also mixed forms in which a heart valve has both a stenosis and an insufficiency with varying degrees of severity.

What symptoms and complaints typically occur in patients with structural heart disease?

Many valve diseases can be tolerated for a very long time without symptoms. If symptoms are present, this is usually a sign of advanced disease. Certain valve diseases can cause symptoms similar to those of coronary heart disease, including chest tightness and pain. Another consequence can be the gradual onset of breathlessness, which leads to a decline in everyday performance. Patients with a severe narrowing of the aortic valve, known as aortic stenosis, often suffer a typical circulatory collapse, known as syncope. This results in brief loss of consciousness due to impaired blood circulation in the brain. In the advanced stages of mitral regurgitation, symptoms may include shortness of breath, fatigue, fluid accumulation in the lungs, swollen legs and cardiac arrhythmia with atrial fibrillation.