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Cardiolucent

Condition

Valvular heart disease

Conditions

Valvular heart disease refers to problems with one or more of the heart's four valves, which normally open and close to keep blood moving in the correct direction. Valves can either narrow (stenosis), forcing the heart to work harder to push blood through, or fail to close fully (regurgitation), allowing blood to leak backward. Either pattern strains the heart over time and, if unaddressed, can progress to heart failure, atrial fibrillation, or sudden cardiac events. Modern echocardiography — including the strain imaging Dr. Kedan uses at the visit — allows valve disease to be tracked with great precision so that intervention is timed at the optimal moment, neither too early nor too late. When intervention is needed, Cardiolucent coordinates with the structural heart and cardiac surgery teams at Cedars-Sinai.

What Cardiolucent Evaluates

  • Transthoracic echocardiography with strain imaging to grade severity and quantify chamber response
  • POCUS at every visit for interval reassessment without scheduling delay
  • Symptom screening for exertional dyspnea, lightheadedness, syncope, and palpitations
  • Left ventricular function, hypertrophy, and atrial size assessment
  • BNP/NT-proBNP biomarker tracking for early signs of cardiac strain
  • Endocarditis prevention counseling for higher-risk patients
  • Concurrent coronary disease evaluation when valve intervention is being considered
  • Coordination with structural heart and cardiothoracic surgery at Cedars-Sinai

Common Symptoms

  • Shortness of breath with exertion or when lying flat
  • Reduced exercise tolerance and fatigue
  • Chest pressure or discomfort, particularly with aortic stenosis
  • Lightheadedness, near-fainting, or syncope, especially with exertion
  • Palpitations, often from new atrial fibrillation
  • Leg swelling or abdominal bloating as cardiac filling pressures rise
  • A heart murmur detected on routine physical exam, often the first clue
  • Many patients are asymptomatic for years and identified only on imaging or auscultation

Risk Factors

  • Age-related calcific degeneration, particularly of the aortic valve
  • Congenital valve abnormalities such as bicuspid aortic valve
  • Prior rheumatic fever (more common in patients from regions where it remains prevalent)
  • Prior infective endocarditis
  • Long-standing hypertension
  • Underlying cardiomyopathy or coronary artery disease
  • Chest radiation history for prior malignancies
  • Connective tissue disorders such as Marfan syndrome
  • Certain medications historically associated with valve disease

How Cardiolucent Approaches Treatment

Dr. Kedan manages valve disease primarily through accurate, frequent surveillance and medical optimization while watching for the inflection points that should trigger intervention. The cadence of echocardiography is tailored to the specific valve and severity rather than a one-size schedule, with POCUS at office visits filling the gaps in between. Medical therapy targets blood pressure, rhythm control, and heart failure symptoms while the underlying valve is monitored. When repair or replacement becomes appropriate — surgical valve replacement, TAVR, transcatheter mitral or tricuspid repair — Dr. Kedan coordinates timing and referral directly with the Cedars-Sinai structural heart team, and resumes long-term follow-up afterward.

Common Questions

Frequently Asked Questions

What is valvular heart disease?
Valvular heart disease refers to problems with one or more of the heart's four valves, which normally open and close to keep blood moving in the right direction. Valves can either narrow (stenosis), making it harder for blood to pass through, or fail to close fully (regurgitation), allowing blood to leak backward. Either pattern forces the heart to work harder and, over time, can lead to heart failure if not addressed.
What causes valve disease?
Common causes include age-related calcification, congenital valve abnormalities such as a bicuspid aortic valve, prior rheumatic fever, infections of the valve (endocarditis), and changes related to heart muscle disease. Some valve issues are present from birth but only become significant in midlife or later. Identifying the cause helps Dr. Kedan predict how the disease is likely to progress.
What are the symptoms?
Many valve problems are silent for years and are first detected as a heart murmur during a routine exam. When symptoms emerge, they often include shortness of breath, reduced exercise tolerance, fatigue, lightheadedness, chest discomfort, or palpitations. The appearance of symptoms is one of the most important triggers for considering intervention.
How is valve disease evaluated?
Echocardiography is the cornerstone of diagnosis and follow-up, providing detailed images of valve structure, motion, and the severity of any leak or narrowing. Dr. Kedan uses POCUS during office visits and arranges full echocardiographic studies when more detail is needed, supplemented by stress echo, cardiac MRI, or transesophageal echo in select cases.
Will I need surgery?
Many patients with mild or moderate valve disease never require surgery and are monitored over time with medical management. When valve disease becomes severe — or causes symptoms or heart strain — repair or replacement is considered, and modern transcatheter techniques have made intervention safer and less invasive for many patients. Dr. Kedan coordinates timing and referral with cardiothoracic and structural heart specialists at Cedars-Sinai.
What is the difference between valve repair and valve replacement?
Repair preserves your own valve by reshaping or reinforcing it and is often the preferred approach when feasible, particularly for the mitral valve. Replacement substitutes a mechanical or tissue (bioprosthetic) valve and is the standard for many aortic valve problems. The right choice depends on the specific valve, the type of disease, and your age and lifestyle, all of which Dr. Kedan reviews with you in detail.
What happens if valve disease is left untreated?
Severe untreated valve disease can lead to heart failure, atrial fibrillation, pulmonary hypertension, and in some cases sudden cardiac events. The risk depends on which valve is affected and how severely. Regular surveillance allows Dr. Kedan to intervene at the optimal moment, before irreversible damage occurs.
How often will I need follow-up?
Mild disease is typically reassessed every 1–2 years, moderate disease every 6–12 months, and severe disease every 3–6 months or sooner if symptoms change. New or worsening shortness of breath, chest discomfort, or fainting should prompt a visit between scheduled checks. Schedule a consultation with Dr. Kedan to establish the cadence that fits your specific valve and stage.
Are there medications that fix valve disease?
No medication can repair a damaged valve, but the right medications can manage symptoms, control blood pressure, treat associated rhythm problems, and slow strain on the heart. The goal of medical therapy is to preserve heart function while monitoring for the moment intervention becomes necessary.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.