Q. I am a 66-year-old white female in generally good health except for a heart valve that is closing up. I have had three tests, the last of which revealed no change in the valve since the previous test three months ago. My doctor wants me to do another test in three months, because he says the valve will have to be replaced sometime. Should I have any other kind of test or more frequent tests to determine if surgery needs to be done sooner?
A. There are two major heart valves, the aortic and mitral. Narrowing of either of these valves is cause for concern but generally such narrowing occurs very slowly. Following you with ultrasound testing every three to six months is quite reasonable.
You don't want to have the surgery any sooner than necessary, rather you should have it only when you have either a critically narrow valve or symptoms such as shortness of breath, chest pain, or dizziness. At some point, when your doctor thinks it is close to that time, you will also need a cardiac catheterization to see if your coronary arteries also are blocked and need to be bypassed. This will be done just before the heart valve surgery.
It is a good sign that there has been no change in the degree of narrowing and hopefully this will continue for some time.