Maintaining heart health is crucial for overall well-being.
STAYING active is essential for a healthy life, but jumping into strenuous exercise without understanding one’s own heart's health can also be risky. While heart health is often viewed as a concern for the elderly, young people can also be at risk, especially if they are unaware of underlying issues.
Cardiology department deputy head and consultant cardiologist Datuk Dr Azmee Mohd Ghazi of Institut Jantung Negara (IJN) elaborates, “Athletes who push themselves too hard without rest or those making a sudden leap from a sedentary lifestyle to intense workouts, can unknowingly face heart-related problems.”
Known as ‘the forgotten valve’, the tricuspid valve is a critical yet often overlooked part of heart health. It ensures smooth blood flow from the heart's right atrium to the right ventricle. When the valve isn’t functioning properly, it places extra stress on the heart, potentially leading to severe complications such as heart failure.’
Datuk Dr Azmee Mohd Ghazi.
“The prevalence in Malaysia remains unclear, but generally we're looking at up to about 1-2% of patients diagnosed with tricuspid valve disease worldwide,” Dr Azmee shares.
Tricuspid valve disease can manifest in various forms, with tricuspid regurgitation being the most common. Known as a leaking valve, it occurs when the valve does not fully close, resulting in blood leaking backwards into the heart’s chambers.
Another one, known as tricuspid stenosis, is a rarer form that involves the narrowing of the valve which restricts blood flow. Meanwhile, tricuspid atresia is a congenital defect present at birth where a valve is missing entirely, leading to abnormal blood flow.
Tricuspid valve disease can result from various conditions including endocarditis (an infection of the valve), rheumatic fever, chronic hypertension and atrial fibrillation (irregular heartbeat).
Keep your heart in check
The contributing factors often manifest early as symptoms like fatigue and shortness of breath. These are often subtle and easily overlooked which can result in delayed diagnosis and progression to a more severe stage.
Dr Azmee illustrates, “Patients who feel breathless often assume that it's probably their stamina or their age that they are not able to do their normal activities. Ignoring these early signs can cause the condition to gradually worsen, leading to abnormal heart rhythms and swelling in the legs and abdomen, which may eventually result in heart failure.”
Individuals with diabetes, hypertension, a family history of heart disease, smokers and those over the age of 40 face a higher risk of tricuspid valve disease.
Dr Azmee notes that while some risks can be managed with lifestyle changes, tricuspid valve disease cannot always be fully prevented. Therefore, a combination of monitoring risk factors and undergoing regular cardiac screenings is crucial for early detection. The screening typically includes a thorough physical examination by a doctor, an electrocardiogram (ECG), blood tests, stress tests and echocardiograms.
“When you undergo a screening like this, many aspects of your heart health are assessed, not just tricuspid valve disease,” Dr Azmee explains.
The insights gained from comprehensive screenings guide the subsequent approach to treatment. Thanks to recent advancements in healthcare, the range of treatment options has significantly broadened.
Evolution of heart care
Initially, healthcare professionals may recommend medication to manage mild symptoms before transitioning to palliative care for more severe cases.
For patients with a diseased or damaged tricuspid valve, repair or replacement typically requires open-heart surgery. However, such surgeries may pose risks for elderly patients or those with comorbid conditions. Fortunately, technological advancements now provide more minimally invasive alternatives for high-risk patients such as transcatheter therapies in treating leaking valves.
Dr Azmee outlines, “The minimally invasive therapy allows us to treat the leaking valve using methods such as clipping it with a TriClip or performing a valve replacement with a TriValve. These approaches are particularly useful for patients with severe tricuspid regurgitation or advanced valve disease.”
With these new treatment options, patients can have greater confidence in their care.
Dr Azmee stresses that everyone must take precautions when it comes to heart health. “Even if you're asymptomatic, it's beneficial to get screened. Symptoms can be subjective and even fit individuals can mask signs of heart disease. Screening is important for everyone.”
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