A/Prof Peter Fahmy

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Locals urged to put a focus on heart health

Doctors are urging Penrith residents to use their heads when it comes to their hearts to help curb rising rates of undiagnosed heart valve disease.

More than half a million Australians are living with heart valve disease where blood flow is disrupted through the heart, while more than a quarter of a million Australians have faulty heart valves, and don’t know it.

The plea coincides with the Baker Heart and Diabetes Institute whitepaper titled Our Hidden Ageing: Time to Listen to the Heart that projects that undiagnosed cases will spiral from an estimated 254,000 this year to 435,000 in 2051.

Interventional and Structural Cardiologist, A/Prof Peter Fahmy said the risk of developing heart valve disease increases with age.

“Ageing causes the blood vessels to progressively lose elasticity and become stiff, impacting the vascular structure and function, and this arterial damage also increases mechanical stress on the valves,” he said.

“If not identified, or treated, heart valve disease can compromise heart rhythm, and cause blood clots, stroke, heart failure, and death. Fortunately, heart valve disease can usually be detected by a doctor listening to the heart sounds.”

Colin McFarlane from Jordan Springs has had an aortic valve replacement to treat the disease.

“I had rheumatic fever which they think affected it and I had a heart murmur which is a common symptom that was picked up when I was 14 at a school check-up,” Mr McFarlane said.

“I had shortage of breath because the heart wasn’t pumping as well as it should be so I ended up having the valve replaced in 1973, which is still going strong.”

The 83-year-old encourages people of all ages to make their heart health a priority.

“You don’t have to be older, if you are any age and have concerns or pain you should get it checked out,” he said.

“The doctors can do an amazing job, you just have to make sure that you are taking your health seriously.”

A/Prof Fahmy said the development of non-surgical valve replacement, such as transcatheter aortic valve implantation (TAVI) has changed treatment outcomes.

Treatments and other conditions:

TAVI (Tranascatheter Aortic Valve Insertion)

Transcatheter aortic valve implantation (TAVI) is a procedure that allows an aortic valve to be implanted using a long narrow tube called a catheter. Usually, the catheter is inserted into a large blood vessel in your groin or through a small incision in your chest.

Percutaneous Coronary Intervention (PCI)

Percutaneous Coronary Intervention (PCI) is sometimes called, an angioplasty with stent. PCI is a non-surgical procedure that uses a catheter to place a stent in the blood vessel of the heart that has been narrowed by plaque build-up.

Adjunctive imaging can also be used to further assist in coronary intervention such as IVUS and OCT.

Diagnostic imaging such as Intravascular Ultrasound (or IVUS) lets cardiologists see inside a coronary artery in real time, yielding information beyond routine imaging methods such as coronary angiography or non-invasive Multislice CT scans.

Intravascular optical coherence tomography (OCT) can add value to angiography as a diagnostic and/or intervention tool for percutaneous coronary intervention (PCI) guidance.

Rotablation

This is a procedure which attempts to “bore out” a narrowing in a coronary artery which might not otherwise respond to stenting.

Intravascular ultrasound

Intravascular Ultrasound (or IVUS) lets cardiologists see inside a coronary artery in real time, yielding information beyond routine imaging methods such as coronary angiography or non-invasive Multislice CT scans.

ASD and PFO closures Patent Foramen Ovale (PFO)

The heart is divided into four chambers. The upper chambers are called the right and left atria. The lower chambers are the right and left ventricles. In fetal circulation, the foramen ovale is an opening that allows blood to bypass the lungs and go directly from the right atria to the left atria. Shortly after birth, the higher pressure in the left atria and the lower pressure in the right atria causes permanent closure of the foramen ovale in the majority of people. A PFO occurs when the opening does not close. This opening can allow blood to pass from the right atria to the left atria. Many times a PFO is not discovered until adulthood.

PFO’s are suspected to be a cause of cryptogenic stroke (a stroke that cannot be linked to a specific cause). Some research suggests there may be a link between PFO’s and migraine headaches.

Atrial septal defect (ASD)

An ASD is a hole in the part of the septum that separates the atria—the upper chambers of the heart. This heart defect allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing to the left ventricle as it should. Many children who have ASDs have few if any, symptoms.

DIschemic Heart disease

Ischemic heart disease occurs when there is reduced blood supply to the heart.

Structural Heart Disease (SHD)

People with structural heart disease fall into two categories:

  1. People are born with the disease – i.e. a hole within the chambers of the heart
  2. They acquire  SHD through wear and tear – i.e. a tight or leaky heart valve.
Heart Failure

Heart failure occurs when the heart muscle has become too weak or too stiff to pump blood through the body as effectively as normal.

Arrhythmias

Heart arrhythmia refers to a group of symptoms where the heartbeat is irregular, too slow, or too fast. Arrhythmias are broken down into:

  • Slow heartbeat (bradycardia).
  • Fast heartbeat (tachycardia).
  • Irregular heartbeat (flutter or fibrillation).
  • Early heartbeat (premature contraction).