Structural heart disease is a condition that affects the heart’s valves, chambers or walls. It can be present at birth (congenital heart disease) or develop later in life due to aging, calcium buildup, infection or other health conditions.

Unlike heart rhythm problems or blocked arteries, structural heart disease involves changes to the heart’s physical structure. When a valve becomes narrowed or leaky, or when there is a hole between heart chambers, blood cannot flow properly. This forces the heart to work harder and can reduce the amount of oxygen-rich blood delivered to the body.

Early diagnosis is therefore critical. Regular checkups and cardiac imaging can detect valve disease or structural abnormalities before serious complications develop. However, without proper treatment, structural heart disease can increase the risk of heart failure, stroke, abnormal heart rhythms, pulmonary hypertension and long-term heart damage.

What Are The Types of Structural Heart Disease?

Structural heart disease includes conditions that change how blood flows through the heart’s valves and chambers. Common types include:

• Aortic valve stenosis – Narrowing of the aortic valve caused by thickening or calcium buildup. The valve does not open fully, limiting blood flow from the heart to the body. Symptoms can include chest pain, shortness of breath and fainting.
• Mitral regurgitation – A leaky mitral valve that allows blood to flow backward into the left atrium. This reduces efficient blood circulation and can eventually lead to heart failure if not treated.
• Mitral stenosis – Stiffening and narrowing of the mitral valve, often related to prior rheumatic heart disease. Blood backs up into the lungs, which can cause breathing difficulties and congestive heart failure.
• Atrial Septal Defect (ASD) – A congenital hole between the heart’s upper chambers (atria). This allows oxygen-rich and oxygen-poor blood to mix, putting a strain on the heart over time.
• Patent Foramen Ovale (PFO) – A small opening between the atria that fails to close after birth. In some patients, it can contribute to abnormal blood flow and increase stroke risk.
• Ventricular Septal Defect (VSD) – An opening in the wall between the lower chambers (ventricles). Depending on its size, it can disrupt normal circulation and increase pressure inside the heart.
• Arteriovenous fistula (AVF) – An abnormal connection between an artery and a vein that alters normal blood flow and increases the heart’s workload.

What Are The Causes and Risk Factors of Structural Heart Disease?

Structural heart disease can happen for different reasons, including:

• Congenital heart defects – Abnormal openings or valve problems present at birth, such as atrial septal defects (ASD) or ventricular septal defects (VSD).
• Valve degeneration – Wear and tear on heart valves over time, often related to aging or calcium buildup.
• Infections – Conditions such as infective endocarditis, where bacteria enter the bloodstream and damage heart valves.
• Rheumatic heart disease – A complication of untreated strep infections that can scar and stiffen heart valves.
• Heart rhythm disorders – Ongoing arrhythmias that can enlarge heart chambers and affect valve function.
• Prior heart attack or heart disease – Damage to the heart muscle can alter the structure and performance of valves and chambers.

Structural heart disease causes vary, and so do the risk factors. However, some of the most common include:

• Advancing age – The risk of valve disease and structural changes rises significantly after age 60 due to natural degeneration and calcium deposits.
• Smoking – Tobacco use damages blood vessels and increases strain on the heart.
• Poor diet – Diets high in sodium, saturated fats and processed foods contribute to high blood pressure and heart disease.
• Lack of physical activity – Sedentary lifestyle increases cardiovascular risk.
• High blood pressure (hypertension) – Extra pressure forces the heart to work harder, which can enlarge chambers and strain valves.
• Diabetes – Elevated blood sugar damages blood vessels and increases overall cardiovascular risk.
• High cholesterol – Contributes to plaque buildup and overall heart disease progression.
• Chronic kidney disease – Linked to calcium imbalances that can accelerate valve calcification.

A genetic predisposition can also increase the likelihood of certain valve abnormalities or congenital heart defects. Examples include:

• A family history of congenital heart defects
• Inherited connective tissue disorders that affect valve structure
• Early-onset valve disease in close relatives

What Are The Symptoms and Warning Signs of Structural Heart Disease?

Structural heart disease symptoms vary depending on the type of condition and how much it affects blood flow. Some patients notice early warning signs, while others don’t experience symptoms until the disease has progressed. Because structural problems impact how the heart pumps blood, many symptoms are related to reduced circulation or increased strain on the heart. This leads to:

• Shortness of breath, especially during activity or when lying flat
• Fatigue or reduced ability to exercise
• Chest pain or pressure
• Lightheadedness or dizziness
• Fainting
• Swelling in the legs, ankles or feet
• Heart palpitations or irregular heartbeat

Symptoms Based on Severity

The severity of symptoms often depends on how advanced the structural abnormality is. For instance, mild or early-stage structural heart disease can include:

• Minimal or no noticeable symptoms
• Fatigue during exertion
• Mild shortness of breath with activity

Meanwhile, moderate to severe structural heart disease can include:

• Shortness of breath during routine daily activities
• Swelling in the lower extremities
• Persistent chest discomfort
• Frequent dizziness or fainting episodes
• Signs of heart failure, such as fluid buildup or rapid weight gain

Some structural heart conditions, particularly certain valve disorders or small congenital defects, can remain silent for years. These cases are often detected during routine physical exams or heart imaging studies.

When to See a Doctor

Patients should schedule a medical evaluation if they experience ongoing shortness of breath, chest discomfort, swelling, unexplained fatigue or heart palpitations. Early assessment allows for appropriate testing and treatment before complications develop.

Diagnosis & Tests for Structural Heart Disease

Diagnosing structural heart disease involves a detailed evaluation of symptoms, medical history and advanced heart imaging. Early and accurate structural heart disease diagnosis helps prevent complications such as heart failure, stroke or permanent heart damage.

Initial Evaluation and Medical History

Care for structural heart disease begins with a thorough review of:

• Symptoms such as shortness of breath, chest pain, fatigue or fainting
• Personal and family history of heart valve disease or congenital heart defects
• Past infections, rheumatic fever or heart conditions
• Lifestyle factors like smoking and exercise habits

A physical exam can also help to detect a heart murmur or other signs of valve or structural abnormalities.

Diagnostic Tests

If structural heart disease is suspected after an initial evaluation, specialized cardiac tests are used to confirm the diagnosis and determine its type and severity. These include:

• Electrocardiogram (ECG/EKG) – Evaluates heart rhythm and electrical activity.
• Echocardiogram – Shows heart valves, chambers and blood flow.
• Transesophageal echocardiogram (TEE) – Provides detailed images of valve structure.
• Cardiac MRI or CT scan – Offers advanced imaging of heart anatomy and function.
• Cardiac catheterization – Measures heart pressures and blood flow.
• Blood tests – Identify infection, inflammation or underlying conditions.

Differential Diagnosis

During the diagnostic process, providers need to rule out other conditions with similar symptoms, including:

• Coronary artery disease
• Arrhythmias
• Cardiomyopathy
• Pulmonary hypertension
• Chronic lung disease

A comprehensive evaluation ensures the correct diagnosis and the most effective treatment plan.

How Do You Treat Structural Heart Disease?

Structural heart disease treatment depends on the type of condition, its severity and how much it affects heart function. Options for care can include:

Medications

While medications do not correct structural abnormalities, they help manage symptoms, reduce complications and protect heart function. As a result, they are often part of a broader treatment plan. Medications include:

• Anticoagulants (blood thinners) – Reduce stroke risk in patients with atrial fibrillation or certain valve conditions.
• Antiplatelet medications – Help prevent blood clots after certain heart procedures.
• Beta blockers – Slow heart rate and reduce strain on the heart.
• ACE inhibitors or ARBs – Lower blood pressure and improve heart efficiency.
• Diuretics – Reduce fluid buildup and relieve swelling or shortness of breath.
• Antibiotics – Treat infections such as endocarditis that can damage heart valves.

Lifestyle Changes

Healthy lifestyle choices play an important role in managing structural heart disease and preventing progression. Patients are therefore encouraged to:

• Follow a heart-healthy diet low in sodium and saturated fat
• Engage in regular exercise
• Quit smoking and limit alcohol consumption
• Maintain a healthy weight
• Manage stress
• Attend regular follow-up appointments and monitoring

These changes help control blood pressure, improve circulation and reduce strain on the heart.

Surgical and Procedural Interventions

When structural abnormalities significantly affect heart function, a minimally invasive procedure or surgery may be recommended. Interventions include:

• Valve repair or valve replacement
• Transcatheter Aortic Valve Replacement (TAVR)
• MitraClip for mitral regurgitation
• Atrial Septal Defect (ASD) closure
• Ventricular Septal Defect (VSD) closure
• Patent Foramen Ovale (PFO) closure

These are often performed using catheter-based techniques, which typically result in shorter recovery times compared to traditional open-heart surgery.

Ongoing Care and Management

Long-term monitoring is essential for patients with structural heart disease. For instance, follow-up appointments allow providers to evaluate heart function, adjust medications and monitor for complications. Some patients can also benefit from cardiac rehabilitation programs that provide supervised exercise, education and support to improve cardiovascular health after a procedure.

What Are The Complications and Long-Term Effects of Structural Heart Disease?

Structural heart disease can lead to serious health complications if not properly treated or monitored. In fact, untreated abnormalities can do more than strain the heart muscle, but also impact other organs over time. Potential complications can arise as a result, such as:

• Heart failure – When the heart cannot pump enough blood to meet the body’s needs.
• Stroke – Blood clots that form due to abnormal blood flow or atrial fibrillation.
• Arrhythmias (irregular heart rhythms) – Structural changes that disrupt the heart’s electrical system.
• Pulmonary hypertension – Increased pressure in the blood vessels of the lungs.
• Endocarditis – Infection of the heart valves or inner lining of the heart.
• Progressive valve damage – Worsening narrowing or leakage over time.

Even with lifelong monitoring and successful treatments, patients can still experience:

• Reduced exercise tolerance
• Ongoing need for blood thinners or heart medications
• Risk of recurrent valve dysfunction
• Increased likelihood of additional cardiac procedures later in life

How Do You Prevent and Reduce Your Risk of Structural Heart Disease?

Some forms of structural heart disease are present at birth and cannot be prevented. However, many risk factors can be managed. Whether you are working to lower your risk or actively managing a diagnosis, consistent medical care and healthy daily habits are essential to protecting long-term heart function.

Lifestyle Modifications

Healthy choices help reduce strain on the heart and slow disease progression. Key steps include eating a heart healthy diet and exercising regularly, aiming for at least 150 minutes of moderate activity per week or as recommended by your provider. Quitting smoking, maintaining a healthy weight, cholesterol and blood pressure, and reducing stress are also essential.

Regular Screenings and Monitoring

For patients living with structural heart disease, regular screenings and long-term monitoring are another important step. Routine checkups and recommended screenings can detect valve changes or heart murmurs early, allowing for timely intervention. Even after treatment, continued follow-up helps prevent recurrence or worsening symptoms.

Patients are also encouraged to:

• Take medications exactly as prescribed
• Monitor for new or worsening symptoms such as swelling or shortness of breath
• Keep all follow-up appointments and recommended imaging tests
• Pace activities and allow for adequate rest

Participation in cardiac rehabilitation programs, patient education services or support groups can provide additional information and guidance.

The TGH Difference for Structural Heart Disease

Structural heart disease involves changes in the heart’s valves, chambers or walls that can disrupt blood flow and strain the heart. Early detection, accurate diagnosis and appropriate treatment help prevent complications and protect long-term heart function. Management can include medications, lifestyle changes, minimally invasive procedures or surgery, along with ongoing monitoring and support to maintain quality of life.

At Tampa General Hospital’s Heart & Vascular Institute, patients with structural heart disease receive care from a multidisciplinary team of specialists, including cardiac and vascular surgeons, interventional cardiologists, heart failure experts, electrophysiologists and advanced imaging specialists. Our collaborative approach ensures personalized care plans shaped around each patient’s needs.

TGH also offers comprehensive diagnostic tools, advanced imaging and state-of-the-art facilities. This includes multiple cardiac catheterization labs, electrophysiology labs and a hybrid heart valve operating room designed to support complex structural heart procedures.

This commitment to advanced technology and high-quality care has earned national recognition. In fact, Tampa General Hospital is:

• Ranked Top 50 in the Nation for Heart & Vascular Care by U.S. News & World Report for 2025-26
• Recognized by Newsweek as one of the World’s Best Specialized Hospitals for Cardiology and Cardiac Surgery and ranked #1 in Tampa and West Central Florida for cardiac care
• Named among Becker’s Hospital Review’s 100 Hospitals and Health Systems With Great Heart Programs

If you or a loved one is experiencing symptoms of structural heart disease or has been diagnosed with a heart condition, schedule an appointment with the world-class TGH Heart & Vascular Institute by calling (813) 844-3900