Day: September 17, 2024

Thousands of heart valve disease patients may be undiagnosed, ERI specialists warn

FREE HEART SCREENING SERVICE AT ASDA CHESSER ON THURSDAY

  • Heart valve disease (HVD) is a leading cause of death in Scotland – affecting 73,000 people – but many have the condition without knowing it
  • Scottish cardiologist is concerned that almost 30,000 people may not know they have HVD which can be life threatening
  • A free heart check truck is coming to Edinburgh – and hopes to screen over 200 people in just one day!

In Scotland it is estimated that 73,000 people have heart valve disease, but studies suggest that 1 in 3 patients (~26,000) are unaware of it and are undiagnosed.

Disease that affects the valves in the heart, such as aortic stenosis, place individuals at high risk of heart failure and if left untreated could lead to sudden, unexpected death. While HVD can cause symptoms like fatigue, reduced energy levels, and chest pains, it can be symptomless.

This is why the Royal Infirmary of Edinburgh and Glasgow Jubilee Hospital will be offering the people of Scotland free heart checks this week (Thursday 19th September) at the ‘Your Heart Matters’ Truck which will be in Asda Chesser Supercentre, Edinburgh. The truck hopes to check the hearts of over 200 members of the public completely free of charge.

“We would welcome any members of the public aged over 50 to come down and have a free heart check whether they are experiencing symptoms or not,” urges Louise Axten, TAVI and Structural Heart Nurse, Royal Infirmary of Edinburgh 

“We can estimate that in Scotland alone there are almost 30,000 people living with heart valve disease who don’t know it. Undiagnosed and untreated heart conditions like aortic stenosis can be fatal.”

Despite the serious risks associated with heart valve disease, treatment rates remain worryingly low. Scotland has two of the best cardiac units in the world, Royal Infirmary of Edinburgh and Golden Jubilee Hospital in Glasgow, which perform pioneering heart treatments such as TAVI and TEER and keyhole surgeries like SAVR.

Recent data suggests that less than 2,000 people in Scotland are having the most effective treatments (heart valve procedures and surgery) in the country’s specialist cardiology centres. This is just a fraction of the total number of HVD patients who could benefit.

  • There are ~600 TAVI procedures performed annually in Scotland. Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure used to treat severe aortic stenosis by enhancing blood flow in the heart by replacing an aortic valve that fails to open completely. During TAVI, a new valve is inserted via a catheter through a small incision, usually in the groin (transfemoral approach) or chest (transapical approach). Initially, TAVI was an alternative for patients too frail for open-heart surgery to replace their aortic valves. Now, it’s also used for those at lower risk of complications from heart surgery, as research shows its equally effective as traditional surgery after one year.
  • In Scotland, there are ~ 200 Transcatheter Edge-to-Edge Repair (TEER) procedures performed per year. TEER is used to treat mitral regurgitation (TR), a condition where the mitral valve in the heart doesn’t close properly, causing blood to flow backward into the heart. During TEER, a small clip is attached to the mitral valve via a catheter inserted through a vein in the leg. This clip helps the valve close more completely, reducing the backward flow of blood.
  • Surgical Aortic Valve Replacement (SAVR) is a traditional open-heart surgery used to treat severe aortic stenosis. There are less than 1,000 SAVR performed annually in Scotland. SAVR is typically recommended for patients who are suitable for surgery, including those who are at high risk for complications from less invasive procedures like TAVI. During SAVR, an incision is made along the breastbone to access the heart and the damaged valve is replaced with a mechanical or biological one.

Dr Stuart Watkins, Consultant Cardiologist at Glasgow Jubilee Hospital, said: “We believe a significant number of individuals with this potentially life-threatening condition may be undiagnosed.

“Considering the estimated prevalence of heart valve disease and the fact that fewer than 2,000 people in Scotland are receiving the most effective treatments, there appears to be a critical gap in diagnosis, awareness, or access to healthcare—putting many lives at serious risk.”

Dr Jonathan Byrne, UK Lead of the UK’s Valve for Life programme and a Consultant Cardiologist at King’s College Hospital, explained: “There is capacity in Scotland to undertake thousands more procedures and keyhole surgeries annually for people with moderate and severe heart valve disease, but underdiagnosed patients represent a huge challenge for us as they will remain undertreated“,

According to the Scottish Cardiac Audit Programme (SCAP), complication and mortality rates associated with TAVI remain very low. In 2022/23, there were 575 TAVI procedures performed in Scotland, marking a 17.8% increase from the previous year.

Despite the rise in procedures, the safety and effectiveness of TAVI continue to be affirmed by these low complication and mortality rates.