Mary Morris: Heart Valve Disease
February is heart health awareness month. It is a month dedicated to informing community on how to improve and maintain heart health and make lifestyle decisions that support good heart health outcomes. The reality is, however, that African Americans do not experience the same heart health outcomes as their white counterparts. According to the Centers for Disease Control (CDC), heart disease is the leading cause of death for both men and women, with higher rates in African Americans.
This month also brings awareness to Heart Valve Disease (HVD), a type of heart disease that involves damage to one or more of the heart’s four valves that causes them to not open or close properly and disrupts blood flow. Some of the most common risk factors for HVD are family history, cardiovascular diseases and conditions such as high blood pressure, high cholesterol and heart conditions that occur at birth (congenital heart disease). There is significant data that shows while rates of heart valve disease are similar across races, the likelihood of getting a heart valve intervention is lower if you are African American.
Mary L. Morris, who is 90-years-old, received a heart valve replacement last year and has declared that she will remain committed to her health. In a recent interview, she said the key to longevity is to ask your healthcare team the right questions to help make informed decisions and to live a life of balance.
Morris learned she needed a heart valve replacement a few years ago when she went to a routine visit with her primary physician which included an echocardiogram after a murmur (a sound discovered on her heart exam with the stethoscope). “I’ve always had to take an echocardiogram; I’ve been getting them before I was being treated for my scleroderma. But, in 2017, my physician told me I needed to see a cardiologist,” Morris said.
Morris met with several cardiologists seeking different opinions, but knew she needed an intervention to replace her heart valve. “I hadn’t had any symptoms –I knew I had some heart problems, but I wasn’t experiencing anything that led me to think I needed my heart valve replaced,” she said.
Morris made the decision to receive care from Dr. Mario Goessl who is a structural interventional cardiologist at the Minneapolis Heart Institute Foundation. In reviewing registries of patients who have had less invasive transcatheter aortic valve replacements (TAVR), 90% of the patients have been white. Goessl has been leading TVINCITIES a study exploring various potential biases and factors that may be responsible for this disparity in order to address them and improve access to life saving therapies like TAVR.
At 89, Morris wondered if the procedure was appropriate for her. But, she said, Goessl said her health status was good and she could receive the replacement with no problem.
“My whole concern was being 89 and having scleroderma which causes me to have high blood pressure and hardening of the tissue and at the time I had been on hydroxychloroquine for a long time. I did an exam and the doctor told me that I could receive the procedure,” said Morris.
“Aortic valve stenosis is a common heart condition,” explained Dr. Courtney Jordan Baechler, a cardiovascular researcher at the Minneapolis Heart Institute Foundation. “Some people are born with two cusps (instead of three) and that often requires earlier attention when you are younger. More common is aortic valve stenosis (or narrowing) that occurs as we age. This is most often detected with a “murmur” or a sound that we hear when we listen through our stethoscope to your heart.”
“I’ve been mostly taking care of me,” said Morris. “With the scleroderma, that’s a disease that’s a whole different ball game. I had to learn what to do and what not to do. And that is why I am where I am today –I’m not in a wheelchair and I’m still able to care for myself. The only thing that slowed me up a bit was having the valve replaced.”
Morris was prepared to have her heart valve replaced, but the procedure was preempted by the COVID pandemic. She asked Goessl if she could wait until she was vaccinated. “I was able to get all of my shots. And then in April 2021, I called Dr. Goessl and scheduled my procedure. On the 5th of April I had an angiogram and then my valve replacement procedure was scheduled for April 20,” said Morris.
The coronary (heart) angiogram, a procedure that uses contrast dye to see how blood is flowing through coronary arteries showed that Morris had a blocked artery. “So, while, Dr. Goessl was performing the valve replacement, he placed a stent in, too,” said Morris.
At Morris’s most recent exam, Goessl told her he’d see her in one year. She’s doing quite well. “You have to change your lifestyle. In order to do as well as I’m doing, I believe, you have to change your lifestyle. Anything that’s going to interfere with healing, my health, I’m not going to do it. I. Come. First. You might think it’s selfish, but it’s not.
“Why should I be doing other things when I know I should be sleeping, or just resting, or doing an exercise. God blessed me to have the knowledge I have going into this,” said Morris.
“If you make-up your mind and decide what’s important in your life, and if you want to live and live decent without having to live in a nursing home or assisted living, you have to learn how to set-up your lifestyle,” said Morris. “You control your body –unless there’s something comes up which you have no control over.”
“Today, we have many more opportunities to replace the valve,” said Jordan Baechler. “Traditionally, we had done open heart surgery, but now often we can use TAVR (Transcatheter aortic valve replacement) which does not require a surgical procedure or as long of a recovery. We know the incidence (or how often aortic valve stenosis occurs) is equal in men, women and all races. We are thrilled Dr. Goessl is helping lead the charge to close these disparities by the study he is leading through the Minneapolis Heart Institute Foundation specifically looking to address this. Knowledge is power, and we hope stories like Ms. Mary’s get the word out about what to look for.”