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Every time your heart beats, it pumps blood to the rest of your body. Structural heart disease is a term for conditions that affect the physical parts of your heart, like the valves, walls, and chambers. These are the parts that help your heart work properly. When something is wrong with these structures, it can make it harder for your heart to do its job.
Structural heart disease describes abnormalities, or defects, in the valves, walls, chambers, or blood vessels of the heart. These problems can be present at birth (congenital heart disease). Or, they can develop later in life due to aging, infection, or other conditions.
These structural problems can affect how well your heart pumps blood, how it moves blood in and out of its chambers, and how it keeps blood flowing in the right direction. When these parts don’t work as they should, it can cause symptoms like breathlessness or chest pain. It can even lead to serious complications like heart failure.
Your heart has four valves that help control the flow of blood — these are known as the aortic, mitral, pulmonary, and tricuspid valves. These valves open and close to let blood in and out of the heart’s chambers. If a valve doesn’t open or close properly, it can cause serious problems. This is called heart valve disease.
In aortic stenosis, the aortic valve becomes too narrow (“stenosis” means narrowing). This makes it harder for blood to flow out of the heart. When this valve doesn’t open fully, the heart has to work harder to pump blood to the rest of your body. This can make you feel tired or short of breath. It can also cause chest pain and fainting.
“Prolapse” means that something slips out of place. In mitral valve prolapse, the mitral valve doesn’t close tightly. It bulges (or prolapses) back into the upper chamber of the heart. This allows some blood to flow backward into the left atrium (chamber). While many people with this condition may not notice any symptoms, some might feel their heart skipping beats or experience shortness of breath.
Congenital heart defects are problems with the heart’s structure that are present at birth. These can range from simple issues — like a small hole in the heart — to more complex problems that need surgery.
Septal defects are one common type of congenital heart defect. A septal defect is a hole in the wall (septum) that separates the heart’s chambers. This hole lets blood flow in a way that it shouldn’t, which can make your heart work harder than it needs to.
In atrial septal defects (ASDs), there is a hole in the wall between the two upper chambers of the heart. Small ASDs might not cause any problems. Larger ones can make the heart work too hard. If not treated properly, ASDs can lead to serious complications, like heart failure.
In ventricular septal defects (VSDs), there is a hole between the heart’s lower chambers. Like ASD, small VSDs might close on their own and not require any treatment. But larger ones can cause problems, including poor growth in children. They could also lead to heart failure.
Cardiomyopathies refer to diseases of the heart muscle. These types of conditions make it harder for the heart to pump blood.
Hypertrophic cardiomyopathy (HCM) happens when the heart muscle becomes thicker than it should be. As a result of the thickened muscle, it’s harder for the heart to pump blood efficiently to the rest of your body. People with HCM might feel short of breath or have chest pain, especially during exercise.
On the other hand, dilated cardiomyopathy (DCM) occurs when the heart muscle becomes too weak and stretched out. It can cause the chambers to get too big and lose their ability to contract. Over time, the heart can’t pump blood as well as it should.
The symptoms of structural heart disease depend on the specific problem and how severe it is. Some common symptoms can include:
To find out if you have structural heart disease, your doctor will likely start with a physical exam and ask about your symptoms. They may then order tests to get a closer look at your heart. We’ll go over some of the most common ones.
An echocardiogram is an ultrasound test that creates pictures of your heart using sound waves. It can help your doctor see if there are any problems with your heart’s valves, walls, or chambers.
An electrocardiogram (EKG/ECG) records the electrical signals in your heart using electrodes (wires that pick up electrical signals) placed on the skin. It can tell your doctor if your heart is beating normally. It can also show if there’s damage to the heart muscle or other structural parts of your heart.
A cardiac MRI uses powerful magnets and radio waves to take detailed pictures of your heart. This test helps doctors see the size and shape of your heart. It can also show any abnormalities in the structure of your heart, such as thickened walls or damaged tissue.
Cardiac catheterization is a procedure where a thin, flexible tube called a catheter is inserted into a blood vessel and guided to your heart. Doctors might use this test to measure the pressure inside your heart. They might also inject a dye that makes it possible to see blood flow through the vessels that supply the heart (coronary arteries). It can help diagnose problems like blocked arteries or valve defects.
Treatment options for structural heart disease depend on a person’s specific condition and what heart structures are affected by it. Talk to your health care team or a cardiologist (heart specialist) to learn the best treatment options for your specific needs.
Many types of medications are available to treat and manage structural heart disease. For example, your doctor might prescribe a beta-blocker to help slow down your heart rate and reduce your blood pressure. By doing so, these drugs make it easier for your heart to pump blood.
Diuretics are also commonly prescribed. These medicines help your body get rid of excess fluid. This can reduce swelling and ease the stress on your heart. Your doctor may also recommend an ACE inhibitor. These drugs work by helping blood vessels relax, reducing the strain on your heart and the potential for heart scarring.
If medications aren’t enough, surgery might be needed to fix the problem. For example, if a valve isn’t working properly, it might require valve repair or replacement surgery. This is typically an open-heart procedure where your doctor removes the damaged valve and replaces it with a new one.
In other cases, you may need surgery to repair a septal defect. Septal defect repair surgery can close holes in the heart, like those caused by ASDs or VSDs. This procedure also requires open-heart surgery so your doctor can access your heart and patch up the holes.
There are also less invasive procedures to treat structural heart disease. One is transcatheter aortic valve replacement (TAVR). This can be used to replace a damaged aortic valve without needing open-heart surgery. Instead, your doctor guides a new valve to your heart through a blood vessel in your leg.
If you have structural heart disease, there are steps you can take to manage your condition and stay healthy. Regular checkups are important. They let your doctor monitor your condition and make any necessary changes to your treatment plan.
Eating a heart-healthy diet, getting regular exercise, and not smoking are all important ways to take care of your heart. If your doctor has prescribed any medications, it’s critical to stick to your medication schedule exactly as prescribed.
Pay attention to how you’re feeling. Let your health care team know if you notice any new or worsening symptoms.
MyHeartDiseaseTeam is the social network for people with heart disease and their family members. On MyHeartDiseaseTeam, more than 61,000 members come together to discuss life with heart disease and share their experiences.
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Vedran Radonić, M.D., Ph.D.
completed medical school and his Ph.D. at the University of Zagreb, Croatia.
Learn more about him here.
Zoe Owrutsky, Ph.D.
earned her Bachelor of Science from the University of Pittsburgh in 2014 and her Ph.D. in neuroscience from the University of Colorado Anschutz Medical Campus in 2023.
Learn more about her here.
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