Editor’s Note: David A. Andelman, visiting scholar at the Center on National Security at Fordham Law School and director of its Red Lines Project, is a contributor to CNN and columnist for USA Today. Author of “A Shattered Peace: Versailles 1919 and the Price We Pay Today,” he formerly served as a foreign correspondent for The New York Times and CBS News in Asia and Europe. Follow him on Twitter @DavidAndelman. The views expressed in this commentary are his.
On Thursday afternoon at 4, I will be ringing the closing bell on the floor of the New York Stock Exchange to mark National Heart Valve Disease Awareness Day, a tribute to the artificial heart valve that was implanted in my chest during open heart surgery over four years ago. Without that procedure and that amazing device, the closing bell on my life would no doubt have rung some time ago.
So, today, I count my blessings to be among the fortunate who are diagnosed and treated for what’s becoming known as a “silent killer.”
Heart valve disease affects at least 5 million Americans, including 1 of 8 people age 75 or older. It’s equally prevalent outside the United States, and has claimed the lives of millions worldwide.
Despite the number of people affected, few people have actually heard of heart valve disease or even realize that in addition to the four chambers of our hearts, we all have four valves, too – the gates that open and close to keep blood flowing effectively one direction through our hearts and in the body. In fact, our heart valves opening and closing generate our heartbeats.
In my case, I’d just turned 69 when I was diagnosed and treated, thanks to my vigilant pulmonologist who thought he’d heard something odd in the stethoscope he used regularly to check my lungs. And since my new artificial valve, handcrafted by a team of two dozen expert technicians in Singapore from the outer covering of a cow’s heart, was implanted, it has beat more than 168 million times.
Heart valve conditions can be present at birth or develop later in life. For me, it was a combination of being born with a bicuspid aortic valve – one leaf shy of the normal three leaves – and calcification or hardening of my valves that grew worse over time and made my valve’s job more difficult because it was operating at only two-thirds normal strength. Because such valves can do their job effectively for decades, they often go undetected until, as in my case, they harden and stop functioning well.
Heart valve problems can develop slowly over time, which can cause symptoms such as loss of stamina, fatigue and shortness of breath – easy to overlook or dismiss, particularly since I have asthma and am often short of breath anyway. Most people affected are in their late seventies or older and, sadly, are more likely to dismiss symptoms as just part of the aging process. These symptoms can also be overlooked as “normal” signs of aging by doctors and family members as well as the person affected. That could be a fatal mistake. Left untreated, severe valve disease leads to death within two years for half the people affected.
Because heart valves create a person’s heartbeat, listening carefully to the heart with a stethoscope is often the first step in detecting a problem. Most murmurs – the sound of blood flowing – are deemed innocent and don’t require treatment, but they can be a sign of something more, particularly if they have changed or are present along with other risk factors. Paying attention to other warning signs is critical as well.
This year’s theme for Valve Disease Awareness Day, “Listen to Your Heart,” is an important one: a reminder to us to be proactive when it comes our health and aging well.
In my case, a simple echocardiogram quickly detected that I had what was developing as a problem. Six months later, the same test showed my valve was deteriorating fast, and needed to be fixed. It was early one December when I asked my surgeon, Dr. Aubrey Galloway, if I could go off to Paris later that month, as planned, to visit my son and my new grandson. “I wouldn’t go to Paris if I were you,” he shot back. That was the wake-up call. Two weeks later, I went in for the surgery.
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Replacing my heart valve has allowed me to continue my career as the foreign correspondent I had been for much of my life – through wars, revolutions and assorted crises in more than 80 countries; and to spend more time with my wife, family and friends.
I wouldn’t be so blessed had some acute physician not listened carefully to my heart, had I not followed up when symptoms worsened and had I not had access to top-notch care. Though heart valve disease cannot be prevented, listening to our hearts for signs of a problem, sharing concerns and seeking care can save lives – just as they did with mine.