What it is
Your heart has four valves that act like one-way doors, helping blood move in the right direction. A valve can become narrowed, stiff or leaky, and any of these changes may affect how smoothly blood flows. Structural heart care is the area of cardiology that looks at these valves and other physical features of the heart.
A heart murmur is a sound a clinician may hear through a stethoscope. Some murmurs are described as harmless, and others may point to a valve or structural question worth looking into. A murmur alone is not a diagnosis, so a qualified clinician usually looks further.
Structural heart care can also include certain heart wall openings and other differences in the heart's build, some present from birth and others developing over time. Some structural and valve conditions can run in families, which is one reason genetic heart testing is sometimes discussed. Genetic tests show risk or carrier status. They do not diagnose heart disease on their own.
How it’s traditionally been approached
Valve and structural concerns have traditionally been approached by starting with a conversation about symptoms, personal history and family history, followed by a physical exam. A clinician may listen to the heart and then recommend imaging, such as an ultrasound of the heart (echocardiogram), along with other tests as they see fit.
When a valve problem is found, many people are monitored over time with regular check-ups. Medicines may be used for related symptoms or conditions. Procedures have traditionally included open-heart surgery to repair or replace a valve. Newer minimally invasive approaches, which use smaller access points, are now also options in some situations.
TAVR (transcatheter aortic valve replacement) is one such approach, and it is typically discussed for certain people with a narrowed aortic valve. Whether TAVR, surgical repair, replacement or watchful monitoring fits a person is decided by a licensed clinician after an evaluation, often with a team of specialists. Each device and procedure has its own regulatory status with the FDA, so it is reasonable to ask a provider about it.
How the right cardiologist may help
The right cardiologist may help you make sense of what a murmur or valve finding means for you. A first visit generally includes questions about your symptoms, health history and family history, a physical exam, and possibly imaging or bloodwork. Bringing a list of symptoms, medicines and relatives' heart histories can make the visit more useful.
If a procedure is being considered, a cardiologist may explain the options in plain language, including how TAVR evaluation or valve repair differs from other paths. Many centers use a heart team that may include a structural heart cardiologist and a cardiac surgeon. You are free to ask for a second opinion at any stage.
Helpful questions to ask include: What is my valve doing, and how was that found? What are my options, including monitoring? What are the benefits and risks of each? Is this approach FDA-cleared or approved for my situation? Would genetic counseling make sense given my family history? How is this typically covered by my insurance? Coverage varies by insurer, state and diagnosis, so confirm with your insurer and provider.
The whole-person view
Body, mind and stress affect one another. Hearing that you have a murmur or valve condition can bring worry, and stress and poor sleep can make the body feel more on edge, including the heart. Looking after your whole self is a natural part of living with any heart question.
Some people find body-based support helpful, such as the approaches offered through Somatic Experiences. Others value talk therapy for working through fear or uncertainty, such as through Therapists.plus. These can sit alongside medical care, and no approach replaces the guidance of your cardiologist.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: anxiety panic and ocd →Therapists.plus: mind body connection →
Keep in mind
- This page is educational only and is not medical advice, a diagnosis or a treatment plan. Licensed professionals should guide your care.
- A cardiologist may help, but no provider, test or procedure can promise a particular outcome or guarantee prevention of a heart attack or sudden cardiac death.
- Before genetic heart testing, consider genetic counseling. GINA protects against genetic discrimination in US health insurance and employment, but it does not cover life, disability or long-term-care insurance, so ask about those first. A negative result does not rule out risk, and a variant of uncertain significance is not a diagnosis.
- For an emergency, such as chest pain, fainting or severe trouble breathing, call 911. If you are in emotional crisis, call or text 988.
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Frequently asked questions
What is heart valve and structural heart care?
Heart valve and structural heart care is the area of cardiology focused on the heart's valves and physical structure. It covers how valves open and close, and how problems may be evaluated and managed. A licensed cardiologist decides what is appropriate after an evaluation.
Does a heart murmur mean I have valve disease?
Not necessarily. A murmur is a sound a clinician hears, and some murmurs are considered harmless while others may relate to a valve or structural issue. A cardiologist may use an exam and imaging such as an echocardiogram to learn more.
What is a TAVR evaluation?
A TAVR evaluation is a set of assessments to determine whether transcatheter aortic valve replacement may be an option for someone with a narrowed aortic valve. It usually involves imaging, a review of your health history and input from a heart team. Whether it fits you is decided by your clinicians.
What are minimally invasive structural heart procedures?
They are procedures that reach the heart through smaller access points, often using catheters, rather than through traditional open-heart surgery. Which procedures exist and who may be considered depends on the condition and the individual. Ask a provider about the regulatory status and suitability of any specific procedure.
Can genetic heart testing help with valve or structural conditions?
Sometimes, particularly when a condition seems to run in a family. Genetic heart testing shows risk or carrier status and does not diagnose disease on its own. Results should be interpreted by a qualified cardiologist or genetic counselor alongside your history, exam, imaging and bloodwork, and counseling before and after testing is recommended.
How do I find the right cardiologist for a valve concern?
Look for an independent cardiologist who treats valve and structural conditions and who is comfortable explaining options and welcoming questions or second opinions. You can ask whether they work with a heart team and which procedures they are familiar with. It is also wise to confirm insurance coverage with your insurer and provider.
Educational resource. CardioGenes shares general information and connects people with independent cardiologists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.