Main
- Heart defect — a persistent disorder of the structure of the valves, septa or major vessels, which disrupts the flow of blood.
- A congenital defect forms in utero, while an acquired one develops after infections, inflammation of the heart or with age.
- Shortness of breath, rapid fatigue, palpitations, chest pain and swelling of the legs help to suspect the problem.
- The main diagnostic method is echocardiography, which shows the structure of the valves, septa and the direction of blood flow.
- The condition is managed by a cardiologist and a cardiac surgeon: observation, selection of therapy and surgery for significant disorders.
What is a heart defect
Heart disease is a disorder of the structure of the valves, septa or major vessels, because of which blood flows not as it should. Some such changes a person acquires before birth, others appear during life under the influence of infections, inflammation or heart diseases.
What happens in the body
The heart works as a pump with four chambers separated by septa, and at the outlet of the chambers there are valves. A valve opens and closes at the right moment, letting blood through in only one direction and preventing it from returning back. If the valve leaflets do not close tightly or, conversely, do not open wide enough, the blood flow is disrupted. Through a narrowed opening less blood passes than needed, and through a loosely closed valve it partially returns back. The septum between the chambers may have an opening, and then blood from one half of the heart enters the other. Because of this, the heart has to work with a greater load to supply the organs with blood. If a person has begun to tire faster under usual exertion or to feel irregularities in the heart's work, this is a reason to discuss the condition with a doctor.
What causes it to develop
- Congenital features of the heart's structure: the disorder is laid down even before birth, when the chambers, septa and valves are formed.
- A previous rheumatic fever: after such an infection the valve leaflets become scarred and stop closing tightly, which changes the blood flow.
- Infectious damage to the valves: the causative agent settles on the leaflets and destroys them, so the valve loses its shape and tightness.
- Inflammation of the heart or its membranes: the inflammatory process affects the muscular wall and the membranes, leaving behind persistent changes.
- Age-related changes and calcification of the valves: over the years calcium salts are deposited on the leaflets, they become denser and open worse.
- High blood pressure and other heart diseases: the constant load on the heart gradually changes its structure and the work of the valves.
Who faces this more often
Heart disease occurs both in children and in adults, but the causes in these groups are different. In children, congenital changes are more often detected: they form in utero and are not infrequently found already in the first months of life. In adults, acquired forms predominate, and their appearance is usually associated with previous infections and inflammation of the heart. A separate group consists of older people, in whom the valves change under the influence of age-related processes and calcium deposition. The frequency is also affected by the general state of the cardiovascular system: with high blood pressure and other heart diseases the load on the valves is higher. Heredity also matters, so it is worth knowing the family history and telling the doctor about it. If close relatives were found to have changes in the valves or septa, it is reasonable to tell about this at the appointment.
What symptoms can occur?
The manifestations of heart disease depend on its type and severity, so different people have different complaints. Below we explain how the first changes are noticed, which signs are most common, and in which cases help is needed without delay.
How it is noticed at the very beginning
Heart disease often goes unnoticed for a long time, and the disorder is found by chance during an examination or tests for another reason. A person begins to tire more quickly after usual activities that used to be easy and did not require a rest. Climbing stairs or the journey to work suddenly comes with breathlessness, although the exertion has remained the same. Such changes are put down to tiredness, lack of sleep, being busy or age, rather than to the heart. Sometimes there are palpitations or a feeling of a racing heart, which also pass on their own and cause no concern. Gradually dizziness, heaviness in the legs towards the evening and discomfort in the chest on movement are added to this. If such signs recur and interfere with everyday activities, it is worth seeing a cardiologist without waiting for the condition to become more noticeable.
Signs that are most common
- Breathlessness: shortness of breath on usual exertion or at rest indicates that it is harder for the heart to supply the body with blood.
- Increased fatigue and weakness: ordinary activities take more strength than before and require frequent pauses for rest.
- Palpitations or a feeling of a racing heart: the rhythm is felt as thuds or pauses, which is noticeable even without exertion.
- Pain or discomfort in the chest: unpleasant sensations occur on movement and may radiate to other areas of the body.
- Fainting or dizziness: a brief loss of consciousness and darkening before the eyes indicate insufficient blood supply to the brain.
- Swelling of the legs and heaviness in the right hypochondrium: towards the evening shoes become tight, and a bloated feeling appears in the abdomen.
When to seek help urgently
Examinations and tests
Examination for a heart defect is built from simple to complex: first the doctor talks and examines, then adds instrumental and laboratory methods. Below is a breakdown of what exactly is prescribed and what information each test provides.
How the examination begins
The examination begins with questioning and a physical examination, during which the doctor may listen for heart murmurs. At the appointment, they clarify when unusual sensations were first noticed and how they changed over time. The doctor pays attention to breathlessness on usual exertion, swelling and rapid fatigue, which a person may not be aware of. The examination includes feeling the pulse and the heart area, as well as measuring blood pressure and assessing skin colour. Listening allows the doctor to detect added tones and murmurs indicating changes in the structure of the valves or septa. To clarify the structure and function of the heart, instrumental and laboratory tests are prescribed, the scope of which is selected individually. Therefore, previously collected discharge summaries and past results help the doctor avoid repeating what has already been done and immediately plan the necessary steps.
What is prescribed and what it shows
What to prepare for the appointment
- Discharge summaries: take all medical documents describing past examinations and conclusions so that the doctor can see the full history of observations.
- Past results: bring the films and descriptions of heart tests already performed, this will save you from repeating some of the procedures.
- List of complaints: write down when breathlessness, swelling or fatigue appeared and how they changed, so that you do not forget anything at the appointment.
- Measurements: if you have been monitoring your pulse and blood pressure at home, show these records, they help assess your condition over time.
- Questions: formulate in advance what you want to clarify with the doctor, this way the conversation will be focused and you will not miss anything.
Which doctor should I see?
A heart defect is managed by a cardiac surgeon and a cardiologist, and the choice between them depends on the severity of the abnormalities. Below is how the first appointment is structured and what areas of care it comprises.
Which specialist manages this condition
A heart defect falls within the remit of a cardiac surgeon, while a cardiologist provides follow-up and selects therapy. The cardiac surgeon assesses the structure of the valves and septa and determines whether surgery is needed and when it is best performed. The cardiologist monitors the patient's wellbeing, keeps an eye on the strain on the heart and, if necessary, refers the patient to a surgeon. At the first appointment, the doctor clarifies the complaints, the history of the condition and how the person tolerates their usual levels of exertion. The doctor examines the patient, listens to the heart and compares this with the findings of previous investigations. If a specialist of this profile is not available nearby, start with a cardiologist at your place of residence: they will determine whether a trip to a clinic with cardiac surgery is required. This approach saves time and helps avoid missing the moment when conservative follow-up is no longer sufficient.
What treatment consists of
- Follow-up with a cardiologist and cardiac surgeon: regular examinations by both specialists help to notice changes in time and reconsider the approach.
- Selection of therapy by the doctor: medications reduce symptoms and support the heart's function, but they are not suitable for everyone and do not replace surgery.
- Surgery when indicated: repair or replacement of a valve and correction of the septa are performed when the abnormalities significantly interfere with the heart's function.
- Rehabilitation: a gradual return to exertion after an intervention or during follow-up takes place under the doctor's supervision.
- Follow-up investigations: these are carried out at the intervals recommended by the doctor, and the approach is changed based on their results.
What depends on the patient themselves
The regularity of follow-up with a heart defect largely determines how predictable the course of the condition will be. If a person attends examinations on time and undergoes the prescribed investigations, the doctor sees the dynamics and manages to adjust the approach. Missed visits deprive the doctor of this picture: changes accumulate unnoticed, and complaints appear later than the objective signs. It is important to honestly describe your wellbeing, your tolerance of exertion and how you cope with everyday tasks. It is worth keeping the results of previous investigations and bringing them to the appointment — this helps to compare the indicators. If your wellbeing worsens, do not postpone a visit to the cardiologist, even if the scheduled date has not yet come round. Talking to the doctor about your limitations and concerns is more useful than trying to work things out on your own.
What helps prevent an exacerbation?
Lifestyle and regular monitoring help reduce the risk of exacerbation in heart disease. Below is what exactly depends on the person themselves and why it matters.
What to change in habits
Giving up smoking noticeably reduces the strain on the heart and blood vessels, so this habit requires a decisive review first of all. Moderate physical activity supports the work of the heart muscle, but its volume should be agreed with a doctor so as not to overload the body. Timely treatment of infections and inflammatory diseases is important because an incompletely treated process can cause complications for the heart. Monitoring blood pressure and cholesterol levels helps keep the blood vessels in a calmer state and reduces the risk of sudden deteriorations. Paying attention to how you feel when breathlessness or palpitations appear allows you to notice changes earlier than they become pronounced. Sleep, nutrition and a feasible daily routine also affect how stress is tolerated during the week. If some of the habits are difficult to change, it is better to discuss this with a doctor and move gradually, without drastic decisions.
What should be kept under control
- Blood pressure: it is measured regularly because a persistent increase imperceptibly overloads the heart and blood vessels.
- Cholesterol level: this indicator is checked as prescribed by a doctor, as it is linked to the condition of the blood vessels and the overall risk.
- Infections and inflammatory diseases: they are treated in a timely manner, because an incompletely treated process can affect the work of the heart.
- How you feel during exertion: breathlessness and palpitations should be noticed and remembered so that they can later be described accurately to the doctor.
- Regular check-ups with a cardiologist: they are needed for heart disease, as they allow changes in the condition to be seen in time.
How often to see a doctor
Regular check-ups with a cardiologist are needed even when you feel quite well and nothing is troubling you. Heart disease can change gradually, and outward well-being does not always match the condition of the heart and blood vessels. During a check-up, the doctor assesses blood pressure, listens to the heart and compares this with what the person feels in everyday life. If breathlessness or palpitations appear, this should be mentioned without waiting for the next scheduled visit. When heart disease is present, monitoring becomes a permanent part of life, rather than a one-off measure during a deterioration. Such monitoring helps to notice changes in time and discuss with the doctor what should be adjusted in your habits. Skipping visits is undesirable: a calm period is just the convenient time for a scheduled check.
What is worth remembering
Heart disease is a condition in which the structure or function of the heart's valves and chambers differ from normal, and the discussion of it is worth concluding with a few points. They will help the reader understand what to rely on in further decisions.
Key points
Heart disease does not always manifest clearly, so how one feels is not a reliable guide. A person may feel normal for years, while changes in the heart gradually increase. Regular check-ups, rather than only the appearance of complaints, help to detect them. If a doctor has already mentioned heart disease, scheduled visits should not be skipped even when feeling well. Many serious conditions develop insidiously, and early attention to them changes the course of the disease. Putting off a visit to a specialist when new symptoms appear is a common and dangerous mistake. It is important to rely on the doctor's observation and the results of examinations, not on random advice. Such an approach helps preserve the heart's function and the usual way of life for longer.
