Gasping for air after taking the stairs at work or running to catch a bus is quite normal. But could this symptom be a sign of a more severe condition?
Shortness of breath was one of the symptoms experienced by a 55-year-old patient after vigourous activities like walking or climbing stairs. Upon arrival at the Durdans Heart Centre, he was diagnosed with “Barlow’s Disease” or “Myxomatous Mitral Valve Disease”.
The valves of the heart consist of thin tissue called leaflets. Barlow’s Disease causes the thickening and elongating of these tissues, causing them to fall back into the left atrium (chamber of the heart that receives oxygen-rich blood). This results in a leaky valve (mitral regurgitation).
In this particular case, the valve affected was the mitral valve. Located between the left atrium (upper chamber of the heart) and left ventricle (lower chamber of the heart), this valve is considered to be very important because of its extensive involvement in heart function. It is more beneficial to repair the valve rather than replacing it for the following reasons:
• Eliminates the need for lifelong blood thinners.
• Maximises heart function.
• Lowers risk of infection.
• Improves survival rates.
The patient had a severe form of the disease where all parts of the valve were affected. In the majority of the patients with this disease, only a portion of the valve is affected. Another concern was the degeneration of a chordae tendineae (fibrous strings of tissue that support the valves). This resulted in a flail leaflet and severe leakage, which also contributed to the patient’s difficulty in breathing.
Durdans Heart Centre also discovered an additional defect in the patient’s heart- a hole between the two atria. This is referred to as “Atrial Septal Defect”.
Dr Kesava Dev, Resident Cardiothoracic Surgeon at Durdans Hospital said, “It is gratifying to note that this difficult valve could be repaired and the hole in the heart could also be closed using a minimally invasive approach. It was done through a small incision on the right side of the chest. Avoiding the big central incision allows for a minimally invasive cardiac surgery. Thus we were able to perform a minimally invasive double procedure successfully and safely; to the benefit of the patient.
Dr Madhur Malik, Senior Consultant Cardiac Anesthesia and Intensive Care said “This case underscores the importance of intraoperative transesophageal echocardiography which enabled us to detect the second problem and treat it.”
