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Heart Valve Diagnosis & Treatment

A proper diagnosis is important when living with heart valve disease


Heart valve disease is a condition that can be treated if discovered early, helping you to get back to a good quality of life. If you’re over 65 and experience any symptoms of heart valve disease, it’s important to see your doctor.It’s a good idea to try to keep a record of any symptoms you might have. This can help you to remember to tell your doctor how you’ve been feeling. Also record the exercise you’ve been doing if you’ve been feeling unusually tired, or breathless. Your doctor will look at the following to check for a possible heart valve disorder:

  • Pulse rate and rhythm.

    The doctor will feel your pulse in order to check how fast it is, and whether it has a regular rhythm.

  • Blood pressure.

    Your blood pressure is measured using a gauge with an inflatable cuff that goes around your arm. This measures the force or pressure that your heart needs to use to pump blood around your body.

  • A stethoscope check.

    The doctor will place a stethoscope against your chest to listen to your heart.

The stethoscope is one of the most important checks to listen for a heart murmur or ‘click-murmur’ – normally the first sign of heart valve disorder.

  Follow up tests

If your doctor finds a heart murmur, they will most likely recommend some follow up tests for a more accurate diagnosis. The following tests may be performed:

  • Doppler echocardiogram

This is an ultrasound of the heart which can show if you’ve had previous heart attacks, or if your heart valves are damaged or leaky. It also measures the amount of blood that can be pumped out of your heart every time it beats.

  • Chest X-ray

This shows the size and shape of the heart to identify anything abnormal.

  • Electrocardiogram (ECG)

This test is used to check your heart rhythm or determine if you have an enlarged heart muscle. This is done by measuring the electrical activity of your heart.

  • Radionuclide ventriculography (RNVG, RNA or MUGA scan)

This test is where a small amount of radiation is injected into a vein. A scan is then done which allows the doctor to see the performance of heart muscle, blood flow, and size and shape of the heart’s chambers, while you rest and exercise.

  • Transoesophageal echo (TOE)

This is where a probe is placed down the oesophagus to see an image from behind the heart.

  • Cardiac catheterisation

This is where catheters (small, flexible hollow tubes) are inserted into a vein and an artery to see how well your heart valves and arteries are working.

Treating heart valve disease

If diagnosed early, heart valve disease is treatable and you can live a full, happy life. Treatments for heart valve disease can include medicines and surgery.


It’s not possible to reverse heart valve disease with medicine alone. Sometimes medicines may be recommended instead of surgery if your symptoms are mild, or if valve repair or replacement is not possible.

Medicines may be prescribed to reduce symptoms, maintain the heart’s rhythm, or lower the risk of blood clotting and stroke.

Some medicines that could be prescribed include:

  • Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs)

These manage high blood pressure and in turn, help blood pump around the body.

  • Anti-arrhythmic medication

These help maintain or restore a normal heart rhythm.

  • Antibiotics

These help to prevent infection after surgery.

  • Anticoagulants

These can reduce the risk of blood clots because of poorly circulating blood around faulty heart valves. Anticoagulants are often prescribed for patients with a mechanical heart valve, and can help prevent stroke.

  • Beta-blocker

These work by slowing your heart rate and reducing blood pressure, and can help against heart damage.

  • Diuretics

These can help lower the burden on your heart by reducing fluid in the tissues and bloodstream.

  • Vasodilators

These can help open and relax the blood vessels, reducing the workload of your heart and reducing pressure on leaky valves.


Depending on your symptoms and the overall condition of your heart, your doctor may decide to repair existing heart valves or replace them entirely. An affected valve could be repaired with a ring to support the damaged valve, or it may be replaced with an artificial valve.

Types of surgery for heart valve repair or replacement include:

  • Open heart surgery

This is a highly successful procedure that has traditionally been used to replace or repair heart valves. The procedure usually takes a few hours: a large opening is made in the chest, and the heart is temporarily stopped so that the surgeon can insert a new valve or repair an existing one. Patients usually stay in hospital for a week or more after surgery. The recovery period from this type of surgery is around two to three months, and it leaves a noticeable scar.

  • Minimally invasive valve disease surgery

This is where a camera is inserted through a small opening on the side of the chest, so the surgeon can see the heart and repair or replace the valve. It’s a procedure with a shorter hospital stay than open heart surgery, usually involving a stay of around 4 or 5 days. This form of surgery also involves less risk of infection and scarring, and faster recovery than open heart surgery. Most aortic and mitral valve surgery can be done using this technique, but open heart surgery may be more suitable for people who need more complex valve repairs, or those who have some other health conditions as well as heart valve disease.

  • Transcatheter aortic valve implantation (TAVI)

This is a procedure where a long, flexible tube is inserted through an artery. The tube has a replacement valve attached to one end. Imaging equipment is used to guide the tube, positioning the replacement valve inside the natural valve. Once it is in the right position the replacement valve expands into place, pushing the faulty valve away. The replacement valve starts to work immediately. This is less invasive than open heart surgery, and generally has a shorter recovery time. The procedure usually takes around 1 hour, with a typical hospital stay of 3 to 5 days. It can also be an option for patients where open heart surgery is too risky.

  • Transcatheter mitral valve repair (MitraClip™)

This is a procedure where a long, flexible tube is inserted through a vein in the groin. The tube has a specialized clip attached to one end. Imaging equipment is used to guide the tube, positioning the device inside the natural valve. Once it is in the right position the clip grasps the leaky valve leaflets and reduces the leakiness of the valve. This is less invasive than open heart surgery, and generally has a shorter recovery time. The procedure usually takes around 2 hours, with a typical hospital stay of 3 to 5 days. It can also be an option for patients where open heart surgery is too risky.

There are two types of artificial valves:

  1. Mechanical valves

These valves last for the rest your life. People with this type of replacement valve usually need to take anticoagulant medicine (warfarin) for the rest of their life to prevent blood from clotting around the valve.

  1. Tissue valves

These valves are made from animal tissues. People with this kind of replacement valve don’t need to take anticoagulant medicine long-term. These valves don’t last as long as mechanical valves, so another surgery may be needed later in life.

Shared decision making

Decisions about ongoing care for heart valve disease should be based on an individual’s needs. That’s why shared decision making is so important. Shared decision-making means you have all the information you need to make decisions about the management of your condition with your health care professionals and your family.

You should discuss with your doctors which valve and surgery is most suitable for you so a well thought out decision can be made. A multidisciplinary team (MDT) or ‘structural heart team’ will be available. This is a team of heart valve disease experts who all have different skills, and they will help make sure you receive care that considers your needs, as well as other factors in your life that affect your health and wellbeing.

What to expect

What to expect immediately after surgery

Straight after surgery, patients are usually focusing on basic personal care. You’re encouraged to start the process of getting back to basic things, like getting up, eating and drinking.

Weeks after surgery

A few weeks after surgery, you can expect to gradually return to your normal activity levels. After around three weeks you may be able to walk for up to 10 minutes a few times a day, and by week six you should be able to walk for around 30 minutes.

Follow-up care

Four to six weeks after surgery you’ll generally have what’s called a postoperative visit to check everything is on track. Moving forward, it’s important to have regular check ins with your GP or heart specialist. Check with your medical team about which symptoms mean you should contact your doctor for an extra check-up.

Other things to consider after surgery:


  • Depending on how physically demanding your job is, you will need to take 6-12 weeks off work
  • You will not be able to drive for around 6 weeks. If you have a commercial licence, you will not be able to drive for 3 months and testing will be needed before you can start driving again
  • You can resume sexual activity once you are comfortable enough to do so
  • If you drink alcohol, you can consume small amounts in moderation, but you will need to be careful if you are taking the anticoagulant medicine warfarin. Alcohol can affect the way that warfarin works. Speak to your doctor about safe alcohol consumption if you are taking warfarin.

Recovery after surgery

Part of recovery means keeping up good habits. Below are some suggestions of how you can help your recovery process:

  Embrace a positive physical routine

Exercise when your doctor suggests you can. Physical activity, even if gradual and slow, will help you recover after surgery. Regular exercise will also recharge your mental health and help keep you positive.

  Keep track and weigh yourself every day

You can expect to lose a little weight after your surgery, especially in the first few weeks. Look out for fast weight gain, as this might mean that you are retaining fluid. If you gain more than 2kg, talk to your doctor.

  Congratulate yourself

If you have been through surgery, you should be proud and congratulate yourself. Afterwards, make sure to track the improvements you are making, and be positive about how far you have come.


It’s important to maintain a healthy lifestyle

Incorporating a heart-healthy lifestyle will help your recovery, and help you both mentally physically. These changes could include:


  • A healthy diet can lead to a healthier heart. Eat more vegetables, fruits and embrace whole grains, poultry and seafood whilst limiting salt, sugar and saturated fats.
  • Aim to keep a healthy weight. If you are overweight or obese, your doctor may recommend losing weight.
  • Physical activity is important. It only takes a small amount of physical activity every day to make a difference.
  • Try to minimise stress by doing relaxing activities and spending quality time with friends and family.
  • If you smoke, quitting is good for the health of your heart. Speak to your doctor or call Quitline on 13 7848 for support with giving up smoking.


  Try to maintain a healthy state of mind

The journey from diagnosis to treatment of heart valve disease can be a mental health challenge as much as a physical one. You need to do all that you can to support your mental health moving forward.

Talking to a professional can help with your mental health. Counselling or psychological therapy can be very useful for managing mental health and your condition. Your doctor can provide you with some options, and give you a referral to a psychologist.

Alternatively, to talk to someone at hearts4heart about any concerns you might have about your valve disease, email [email protected]. We can provide you with answers to your questions from a clinician, or a member of the patient advocate group.