Cardiology - The Valve Clinic

What is heart valve disease?

Heart valve disease is when one or more of the valves in your heart become diseased or damaged, preventing them from opening or closing properly. This can affect the ability of your heart to pump blood effectively. Some people are also born with valve problems, this is called congenital valve disease.

Heart valve disease is increasingly common, mainly due to increased life expectancy. About 1 in 40 adults in the general population are affected and this rises to over 1 in 10 in those over the age of 75 years. Sometimes a valve problem never impacts an individual, but close monitoring is important in case it does.

What is the Valve Clinic?

• Heart valve clinics are the gold standard for surveillance of patients with a new or known diagnosis of heart valve disease, heart valve replacement or repair
• The clinic offers guideline-based, streamlined, multi- professional care to patients. It allows detailed assessments of your valve issue at appropriate scheduled intervals
• You will be regularly followed up in the specialist-led clinic and provided with informative literature
• The clinic uses both clinical assessment and appropriate tests to build a clear picture of your heart valve issue

Who will I see during my clinic appointment?

A Highly Specialist Cardiac Physiologist. Your case may be discussed with a cardiologist, and you remain under the overall care of the cardiologist who referred you to us.

What tests will I have?

You will have an echocardiogram or ‘echo.’ This is a scan that uses ultrasound (sound waves) to produce pictures of the heart. The test is without side effects and does not use radioactivity.

You may require a blood test, and occasionally other simple tests such as an ECG.

What are the benefits of these tests?

An echo gives comprehensive information about how well the heart pumps and specifically in your case, how the heart valves are working. If a blood test is required, this can help with understanding any symptoms you may have.

What does it involve?

• The visit will usually start with some questions about any current symptoms. We may ask you to complete a short questionnaire, and then discuss your answers in more detail if required
• For the echo, the person performing the test (the ‘Sonographer’) may be male or female, and not usually a doctor. If you would prefer a sonographer of the same gender, please let us know before you attend
• You will be asked to undress to the waist and put on a gown that should be left open to the front. You will be asked to lie on a couch on your left-hand side, the sonographer may also be sitting on the same couch while performing the scan
• If you would like to request a chaperone to accompany you during the examination, you may request one at the time of booking. This chaperone will be of the same sex where possible, and usually one of the Physiology team. If you would like to request a chaperone on the day of the exam, we will do our best to accommodate
• Stickers will be attached to your chest and connected to the machine to monitor your heart rate. A cuff will be placed around your arm to monitor your blood pressure. The lights will be dimmed during the test
• An ultrasound probe covered by a small amount of gel (which may be cold), is placed on the chest. Images of the heart are taken from different positions – beneath the left breast, beneath the rib cage and to the base of your neck. The pressure from this probe may be mildly uncomfortable, but not painful
• During the echo you will hear sounds coming from the machine, which represent blood flow through the heart
• The echo itself will take approximately 30 to 40 minutes
• We take pride in being an echo training centre, and thus a trainee sonographer may perform the scan under close supervision of a senior physiologist. Here the examination may take up to 60 minutes, but if you would not like to be scanned by a trainee, please let us know before you attend

Are there any special precautions that I need to take before or after the clinic?

No. You can take all your medication as normal. You can eat and drink as normal. There are no limitations to what you can do after the scan, for example, you may drive.

At the end of your clinic appointment

• Once the echo is complete you can get dressed again
• The Cardiac Physiologist will consider the findings of your echo as well as any symptoms you may have
• At this time, you may be given results, a plan for future appointments and any additional investigations that may be required
• Sometimes the Cardiac Physiologist will need time to review the echo or need to ask advice from a cardiologist. You will of course have the opportunity to ask questions, although sometimes we will have to write to you to update you on the plan

Following the clinic a report will be sent to your Cardiologist and a copy to your GP.

Between appointments

Should you find you have new or worsening symptoms or require any further information please contact the Cardio- respiratory Department on 0161 778 2028 (8am-4pm Monday to Friday).

Some common symptoms that patients may experience include:

• Shortness of breath, particularly after physical activity or when lying down
• Swelling of the ankles and feet
• Feeling excessively tired
• Dizziness or fainting
• Irregular heartbeat
• Chest pain or tightness

You can also find further information at https://bhvs.org/