AHA News: A Routine Checkup Led Him to Fix a Leaky Heart Valve Before It Became a Problem

WEDNESDAY, March 16, 2022 (American Heart Association News) -- When Randy Fritz went to his primary care physician for a checkup, he hadn't been to see his doctor in more than a decade, but he wasn't concerned. Why would he be? He played tennis and racquetball regularly with nary a problem. He ate healthy foods. He felt fine.

So, he was shocked by what his doctor told him: He had a heart murmur and needed to see a cardiologist.

"The cardiologist said I had a leaky mitral valve," said Fritz, who lives near Austin, Texas. "I jokingly said, 'So I guess I'll need surgery?'"

"Yes," his doctor said.

"I was being sarcastic!" Fritz replied.

"Sarcastic or not," his doctor said, "you're going to need it."

Then the cardiologist emphasized two points. Even if Fritz felt fine, a leaky mitral valve would eventually degrade his quality of life. It wasn't a question of if but when. And he would be better off repairing the valve while he was healthy.

"Valves in the heart are designed to let blood flow in one direction only," said Dr. Stephen J. Dewan, the cardiothoracic surgeon who performed Fritz's procedure. "Randy's valve was defective and allowed blood to go backwards inappropriately. To compensate, the heart tends to pump more blood."

Left untreated, he said, patients can develop shortness of breath and atrial fibrillation, which need even more intervention.

"We want to interrupt this before the chambers of the heart get too big," Dewan said, "before patients develop symptoms."

Studies show, he added, "that folks who are operated on while they are healthy and asymptomatic tend to do better further down the road" than those who have surgery once they've developed atrial fibrillation.

"That was one of the main things I was told: If I waited too long and got an oversized ventricle, it would not be repairable," Fritz said.

Still, he had no symptoms, which was why his wife and their three grown children struggled to reconcile that this seemingly healthy guy needed heart surgery.

Fritz decided to have an echocardiogram every six months. If it showed his situation was worsening, he'd have surgery.

Everything looked fine until mid-2019. "My cardiologist wanted me to have the surgery in 2020, but the pandemic hit, and elective procedures were being shut down. I didn't want to be in the hospital during that time anyway."

Fritz began going in for tests every quarter. After his echocardiogram in January 2021, almost four years after this cardiac waiting game began, his cardiologist told him, "You can't wait."

So Fritz, who still felt fine, resigned himself to the surgery. He went online to research his condition and the surgery.

"It would have been better if I'd never looked," he said. "You don't want to know all the things they're going to do to you and all the things that can go haywire. That's input you don't need. Nothing positive can come out of that."

He took a deep breath and put his trust in his surgeon, who completely understood Fritz's curiosity.

"I encourage them to do all the homework they want to do," Dewan said. "There's an equal amount of information that is not good and information that is. It's our job to sort through questions and allay patients' anxieties."

Everything went smoothly during the surgery last March, but Fritz was miserable in the days after. He had a terrible cough, was in pain and felt weaker than he ever had in his life. He couldn't help but second-guess his decision.

"The biggest trauma was the week in the hospital when I regretted my decision to have the surgery," he said. "I even told my doctor and surgeon that I wasn't pleased at all."

These days, Fritz – who is 66 – feels about the same as he did when he was initially diagnosed with a leaky mitral valve. He's playing tennis, riding his bike and feeling positive about his health. The difference is, his most recent echocardiogram showed everything to be normal. So now he has the peace of mind of knowing he made the right decision.

"If I'd never gone to the doctor, I probably would have started having a degraded quality of life at some point," Fritz said. "The agony and discomfort I had over a relatively short period of time came and went quickly. Now I have a heart that's going to work properly."

Which brings him to his mission of sorts: to encourage people to have regular checkups, even if they are feeling fine. And, he said, "to help people who are asymptomatic summon courage to have this kind of procedure if need be. I want to turn this experience into something that can be used to advance patient education."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Leslie Barker