From the Guidelines
Structural heart disease encompasses a broad range of conditions, including ischemic heart disease, cardiomyopathies, valvular heart disease, and adult congenital heart disease, as defined by the 2017 AHA/ACC/HRS guideline 1. This term is used to describe abnormalities in the physical structure of the heart, which can be present from birth or develop later in life due to various factors. Some key points to consider about structural heart disease include:
- It can affect the heart's chambers, walls, valves, or major blood vessels
- Conditions such as cardiomyopathies, valvular heart disease, and adult congenital heart disease are all included under this term
- The significance of structural heart disease lies in its potential to impair the heart's ability to pump blood efficiently, leading to symptoms like shortness of breath, fatigue, and chest pain
- Diagnosis typically involves imaging techniques such as echocardiography, cardiac MRI, or CT scans
- Treatment approaches range from medication management to interventional procedures or surgery, depending on the specific condition and its severity, as outlined in the 2017 AHA/ACC/HRS guideline 1. It is essential to note that the definition of structural heart disease may differ across publications, but according to the 2017 AHA/ACC/HRS guideline, it encompasses a wide range of conditions that affect the heart's structure 1.
From the Research
Definition and Scope of Structural Heart Disease
- Structural heart disease encompasses various conditions, including valvular heart diseases, congenital heart disorders, and other abnormalities of the heart's structure 2, 3, 4, 5, 6.
- It includes degenerative diseases of the aortic and mitral valve, as well as dysfunctional tricuspid valve disease, which can result in worse clinical outcomes if severe 3.
- Structural heart disease interventions have seen a dramatic increase, with minimal-invasive, surgical, and/or catheter-based procedures being used to treat these conditions 3, 6.
Types of Structural Heart Disease
- Valvular heart diseases, such as aortic stenosis, mitral regurgitation, and tricuspid regurgitation, are common types of structural heart disease 3, 4.
- Congenital heart defects, which are the most frequent birth defect and a leading cause of death in the first year of life, are also a type of structural heart disease 5.
- Other structural heart diseases include left ventricular outflow tract obstruction, ventricular septal defect, and cardiac shunts 4.
Treatment and Intervention
- Transcatheter aortic valve implantation (TAVI) is a common treatment for severe aortic stenosis, and its indication is shifting toward lower-risk patients and those with complex anatomy 3.
- Other transcatheter technologies, such as edge-to-edge leaflet repair and transcatheter mitral valve implantation, are being developed and used to treat mitral regurgitation and tricuspid regurgitation 3.
- Surgical intervention, including emergent cardiac surgery, may be necessary for patients with decompensated heart failure or cardiogenic shock 4.