Surgeon Q & A: Understanding the Connection Between Heart Failure and Valve Disease with Dr. Edwin McGee
By Adam Pick on March 12, 2013
As we have learned together, failing to properly treat valvular disorders can be tragic for patients, their families and friends. Heart valve disorders — including aortic stenosis and mitral regurgitation — can cause temporary damage to the cardiac muscle and, ultimately, heart failure.
I wanted to learn more about the connection between heart failure and valvular disease so I recently met with Dr. Edwin McGee. This educational video contains the highlights of that interview. For the hearing impaired members of our community, I have provided a written transcript below.
I hope this video helped you learn more about the connection between heart valve disease and heart failure. Many thanks to Dr. Edwin McGee for meeting with me and sharing his clinical experience with our community.
Keep on tickin!
P.S. Here is the video transcript of my conversation with Dr. McGee.
Dr. Edwin McGee: My name is Ed McGee. I’m a cardiac surgeon here at the Bluhm Cardiovascular Institute of Northwestern Memorial Hospital. I’m the Surgical Director of our Center for Heart Failure which includes heart transplantation and mechanical assistance.
Adam Pick: Can you tell us what type of cardiac surgery you specialize in?
Dr. Edwin McGee: Well, thanks Adam. It’s a pleasure talking with you today. I specialized in surgical therapies for patients with heart failure.
Adam Pick: Can you tell everybody what attracted you to that specialty?
Dr. McGee: I always liked to fix things when I was a kid. Cardiac surgery, I think, is the purest expression of that. If someone has a very sick heart you can do a surgery and make it more efficient. Typically, the patient gets better.
Adam Pick: This is a question very common among patients. What is heart failure?
Doctor McGee: Heart failure is a grouping of different symptoms typically include having trouble breathing, breathlessness, lack of energy, fatigue, weight gain, having extra water weight. That’s secondary to having an inefficient heart. A heart that’s not working, as it should, gradually robs patients of quality and length of life — and ultimately failure if not managed properly.
Adam Pick: What is the connection between heart failure and valve disease?
Doctor Edwin McGee: Heart failure and valve disease are very interrelated. Some types of heart failure occur purely by having valves that don’t work as they should. We call that valvular cardiomyopathy. So some people have, for example, an aortic valve that’s too tight or that leaks. Left untreated, that will eventually cause the heart to fail.
Adam Pick: Is being diagnosed with valve disease a direct precursor to heart failure?
Dr. McGee: It certainly can be and that’s a very important thing to sort out. If it’s left untreated it typically will lead to progressive heart failure which ultimately can be fatal. The upside of that is — if we fix the valve or replace the valve, then the patient gets a new lease on life — and they can have a very efficient heart that can last a long time.
Adam Pick: What happens to the cardiac muscle as valve disease progresses?
Dr. Ed McGee: The muscle endures stress. Typically, the heart gets either stretched out — or the muscle gets too bulked up — or too stiff. It can outgrow its blood supply and that leads to an inefficient heart. It’s kind of like the transmission of your car. If the fuel injectors are gummed up, the engine doesn’t run as efficiently as it should and ultimately the engine will fail. It’s very important to have an inefficient valve, a valve that is not working as it should, addressed.
Adam Pick: Is there any timeline in which heart failure can set in after a valve disorder is diagnosed?
Doctor McGee: The problem with a lot of these disorders is that it takes a long time for these valve problems to develop — for a number of years and they’re very subtle changes that the patient experiences in terms of symptoms. Typically, they are not even really aware of the development of symptoms in terms of having trouble breathing, or loss of energy. They just down regulate their lives. Subconsciously they don’t do as much as they used to.
Adam Pick: Is it possible to slow, stop or even reverse heart failure.
Dr. Edwin McGee: With the proper combination of medical therapy and heart valve repair and heart valve replacement surgery, heart failure can certainly be slowed and some cases reversed. Everybody’s different and everybody’s hearts a little different. Definitely a condition that can be managed and often can be made better. That’s one of the gratifying things of surgical therapy for valve problems — the valve is made efficient once again and a lot of times the heart follows.
John O'Neill says on March 12th, 2013 at 4:45 pm
joaquim barretto says on March 19th, 2013 at 12:02 pm
My mitral valve is leaking severely; has been now for over seven years! In my 2006 ECG it was mentioned, “severely leaking mitral valve”. However all these years have passed by and I’ve been asymptomatic. Here in India the doctors were recommending surgery already in 2006, but in Finland (where my wife hails from), they are of the opinion that one should not perform the surgery unless the patients shows some symptoms. I’m 49, but can easily run a couple kms, swim for an hour and do a light work out in a gym.
Please comment as to when would be the ideal time for a surgery if needed.