Early detection with a simple stethoscope check is key
Christian Nielsen returns home after a quick run in his Vancouver neighbourhood where he lives with his wife and two young children. Nielsen works as a management consultant, fulfilling a lifelong dream of owning his own business. On the surface, this might seem like any other day for Nielsen – but he treasures each day with his family after a routine medical check two years ago revealed he had heart valve disease (HVD), a potentially life-threatening condition that turned his life upside down.
A silent condition
Heart valve disease is a common, serious, but treatable cardiovascular condition that affects more than one million Canadians. It occurs when one or more of the valves in the heart do not work correctly.
Like many with heart valve disease, Nielsen had no symptoms, no warning signs to prompt him to seek medical help.
In May 2021, he underwent a routine medical checkup.
“The doctor put a stethoscope on my chest. She had a strange look on her face,” Nielsen recalls. The doctor had detected a heart murmur and told him he would need to see a cardiologist. “It’s difficult to describe that moment. I was in my late 30s. My daughter was only two weeks old. It was quite emotional.”
After another stethoscope check, an electrocardiogram and an echocardiogram, the cardiologist concluded the murmur was the result of a defective aortic heart valve. The faulty valve was “leaking” severely, a condition known as aortic regurgitation, and the left side of his heart had enlarged to compensate.
“They said it was quite dangerous and it would only get worse,” Nielsen says. “Then they told me I needed open heart surgery. A CT scan would give them more information. I was in complete denial.”
On June 10, 2021, Nielsen had the operation, during which they replaced his faulty heart valve with a mechanical valve. The surgery was a success, and he was on his way to a full recovery.
Only seven weeks after his surgery, Nielsen’s heart was back to its normal size. “It just shows the benefits of early discovery and treatment, being fit and living a healthy life,” he says.
Nielsen reached out to Heart Valve Voice Canada to volunteer. “By creating more awareness around early detection, we can really make a big difference here in Canada by reducing hospitalization and costs to the health care system and increasing people’s quality of life.”
As Nielsen’s story shows, people with heart valve disease can lead healthy, active and productive lives with timely detection and treatment.
HVD is a very serious disease, but there are actionable steps people can take to protect themselves. A simple test that can save lives is literally a heartbeat away: A stethoscope check is a simple, non-invasive test during which a doctor uses a stethoscope to listen to the heart for a characteristic heart “murmur” or “click” sound that is usually the first indication of heart valve disease.
Heart valve disease is on the rise
Dr. Jessica Forcillo is a cardiac surgeon who works at the University of Montreal Hospital Centre, focusing on valvular heart surgery (surgical and transcatheter). Dr. Forcillo is among a group of volunteer cardiac surgeons, cardiologists, specialists and heart valve disease patients who are members of the board of directors and champions for Heart Valve Voice Canada (HVVC), a non-profit advocacy organization.
Dr. Forcillo predicts more stories like Christian’s in the future and, sadly, not all will have a happy ending. “We’re going to be confronted with this as Canada’s population ages,” Dr. Forcillo says. “The risk of HVD increases significantly after age 65, and reaches 12.5 per cent after the age of 75. In 2040, Canada will have an estimated 1.5 million people over 65 with heart valve disease (HVD). Between 2007 and 2017, we saw a 68 per cent increase in hospitalization for heart valve disease here in Canada.” This is why every Canadian over 60, or with a pre-existing valve condition, should receive an annual stethoscope check as part of their routine checkup.
Dr. Forcillo says COVID-19 and the move to virtual medical appointments in the past several years has contributed to a lack of early detection of heart valve disease. “As a result, some of these patients are seen at the hospital with more advanced disease,” she says.
It is important that the Canadian population needs to know the symptoms of HVD that may include: shortness of breath, fainting, coughing, chest tightness and/or pain, fatigue, light-headedness or dizziness, and an irregular heartbeat. Because those symptoms aren’t always severe or visible and are often seen as a natural part of aging, many discount them. Furthermore, some people diagnosed with HVD are asymptomatic.
Searching for answers
Dr. Philippe Pibarot is a professor with Laval University and holds the Canada research chair in valvular heart disease. He is also a board member with HVVC. His research aims to improve the diagnosis, prevention and treatment of HVD. Dr. Pibarot says the problem with heart valve disease is that it is insidious and can progress for several years without any symptoms. “There is a huge and urgent need to better screen and detect for the disease,” Dr. Pibarot says.
Advances in the treatment of heart valve disease have led to more treatment options for patients than ever before. Developments in mechanical and tissue valves and the introduction of minimally invasive procedures have been revolutionary, allowing longer and better quality of life, shorter recovery times, and more options for people who may not have been candidates for surgery in the past.
“HVD is both frustrating and fascinating; we have not yet found any drug to slow or halt the progression of this disease,” says Dr. Pibarot, who is the principal investigator of several multicentre studies and trials funded by the Canadian Institute of Health Research. “We are at the point now where we have several great potential candidates with trials starting. In a few years we may have medication to slow the progression of valvular disease.”
Heart Valve Voice Canada encourages Canadians to meet with their health care provider for a regular stethoscope check that could save their lives. Learn more at www.heartvalvevoice.ca.