Detecting Valvular Heart Disease
February is American Heart Month

By: Dr. Elizabeth Cosmal-Cintron, Florida Heart Associates

Valvular heart disease is a condition that affects one or more of four valves within the heart chamber.  Although not as common as coronary artery disease, which is considered the leading cause of death among men and women, valvular heart disease is still a common cardiac condition with increasing frequency among the elderly population.

Valvular heart disease can damage or affect the mitral, aortic, tricuspid or pulmonary valves of the heart.

You see, the mitral and tricuspid valves control the flow of blood between the atria and the ventricles, or the upper and lower chambers of the heart.  The pulmonary valve controls the flow of blood from the heart to the lungs, and the aortic valve directs blood flow between the heart and the aorta, and finally the blood vessels to the rest of the body.

Normally functioning valves ensure that blood flows with proper force in the proper direction at the proper time.  But when the valves become too narrow, hardened, or unable to close, valvular heart disease is most often the cause.

There are numerous causes of valvular heart disease including underlying congenital abnormalities, infections, degeneration of the heart valves and ischemic conditions (i.e. valve dysfunction as a result of a heart attack).  Congenital valve disorders occur prior to birth and can include structural malformations (i.e. bicuspid aortic valve) or irregularities in valve attachments.

Rheumatic fever is uncommon in the United States, but it frequently occurs in developing countries and may cause valvular heart disease.  Infective endocarditis can occur if a bacterial or fungal organism enters the bloodstream and settles onto a heart valve.  And degenerative valve disease involves thickening of valve leaflets or deposition of calcium onto valves that can eventually lead to significant leaking or inability of the valve leaflets to fully open.

Valvular heart disease is a condition that affects one or more of four valves with the heart chamber.

Transthoracic echocardiography (TEE) is an imaging modality used in evaluating heart valves.  If there is a valve disorder, a TEE can quantify the severity, as well as provide information regarding the function of the heart muscle and if there are other cardiac abnormalities present, such as pulmonary hypertension.

A Transesophageal echocardiogram (TEE) is a more invasive procedure in which an endoscope is placed into the esophagus to evaluate the valvular structures with even greater clarity, using ultrasound.  This imaging modality can provide essential information to a cardiovascular surgeon in the event a valve needs to be replaced.

Yet another invasive procedure that utilizes catheters to obtain pressure measurements directly within the heart and to provide calculations regarding the severity of a blocked or regurgitant heart valve is a cardiac catheterization.  During this procedure, a long, thin, flexible tube called a catheter is put into a blood vessel in the arm, groin (upper thigh), or neck and threaded to the heart.  Through the catheter, the doctor can perform diagnostic tests and achieve treatments on the heart.

Initial management of valvular heart disease often involves the use of heart-rate-slowing or blood-pressure-lowering medications.  Medications that help lower cholesterol levels, such as statins, are often used as well.  Patients need to be closely monitored by their cardiologist to determine if the valve disorder is worsening despite aggressive medical therapy.

Once it is established that a heart valve requires surgical intervention, a team of physicians, including the cardiologist, cardiothoracic surgeon, and anesthesiologist, work together to determine whether a valve can be repaired or often times replaced.  A valve replacement can involve using a bioprosthetic (tissue) or mechanical valve.  There are numerous reasons regarding the choice of which type of valve is to be used, including the age of the patient, the patient’s co-morbidities, and whether a female patient is of child-bearing age.

Recently, a new surgical technique called a Transcatheter Aortic Valve Replacement (TAVR) was developed to treat inoperable and high-risk patients.  This procedure enables a balloon expandable aortic heart valve to be placed into the heart through a catheter by entering the femoral artery and then maneuvering the catheter into the aortic valve position, thus “replacing” the native aortic valve.

Valvular heart disease is a well-recognized cardiovascular condition that, thanks to modern medicine, can be detected and effectively managed through advanced medical and surgical therapies.

– Dr. Elizabeth Cosmai-Cintron is a board certified cardiovascular disease specialist with Florida Heart Associates. She is interested in educating people on preventive heart care and maintaining good heart health through proper nutrition, exercise and reducing risk factors that leads to heart disease. For more information or to schedule an appointment, please call her office at 239-938-2000 or visit her website at


Sometimes we just need a little boost!

Speeding up your metabolism with the right foods, exercise and dietary supplements can kick weight loss into high gear.

Winter weight loss should be in full effect right about now; however, burning off the food you eat comes down to your metabolism.

Metabolism is the speed at which the body breaks food down to use its nutrients.  The faster your metabolism the more the body promotes weight loss and muscle growth.  Nonetheless, eating the right foods and exercising correctly isn’t the only answer.  Dietary supplements can help make all the difference.

Try these dietary supplements and kick your metabolism and weight loss into high gear:

L-Glutamine- L-Glutamine is the most abundant, naturally occurring, free amino acid found within skeletal muscle and blood.  Essential to proper function of the immune system, consuming L-Glutamine can help boost protein synthesis and maintain muscle mass, which translates into more effective training and improved performance.  In addition, L-Glutamine plays a role in breakdown of fat metabolism since it helps with the burning of fat instead of muscle.

Vitamin D- Adequate Vitamin D levels help the body respond to insulin, which lowers the chances of the food you eat being stored as fat.  Vitamin D is also good in preventing muscle weakness, muscle composition and function and regulating the immune system responses.  Low levels of this vitamin have been found to interfere with leptin, a hormone that signals the brain to stop eating when it’s full.  The easiest way to get Vitamin D is through sunlight, but Vitamin D is also available in sardines, cow’s milk, eggs and salmon.

Omega 3- Studies have shown that dieters taking omega-3 fish oils lose more body fat while increasing lean mass than their dieting counterparts.  This essential fatty acid helps regulate insulin levels, allowing fat to be used for energy, which results in fat loss. It also help reduce inflammation and improve the body’s blood flow to muscles during exercise, increasing the overall benefits of your workout.

Probiotics- Probiotics are tiny bacteria that live in the digestive tract.  This healthy bacteria fights the unhealthy bacteria caused by stress, daily environmental chemical load or prolonged antibiotic use.  Gut bacteria can play a role in obesity by helping your body regulate metabolism and reducing the likelihood of metabolic syndrome.  A digestive tract with healthy probiotics can help improve digestion to aid your body in absorbing nutrients effectively, burning calories and resulting in a quicker metabolism and higher energy levels.

Coconut Oil- Coconut oil is a rich source of medium chain fatty acids.  These are easily digested, immediately burned for energy and have been found to enhance athletic performance.  Coconut oil also boosts your metabolism and helps your body use fat for energy.  Not only is this tropical saturated fat a natural moisturizer, it’s also been found to boost thyroid function and promote lean body mass.

– Before taking these and any other supplements, be sure to consult your physician or health professional for advice.