Evidence-based Assessment and Management of Valvular Heart Disease
What is Valvular Heart Disease?
Valvular heart disease refers to any disorder affecting the heart’s four valves (mitral, aortic, tricuspid, and pulmonary). Dysfunction may be due to stenosis (narrowing), regurgitation (leakage), or a combination of both, leading to altered blood flow, chamber re-modelling, and heart failure.
Aortic Stenosis (Research Focus)
Aortic stenosis is a condition where the aortic valve becomes narrowed, affecting blood flow from the heart. It is one of the most common valve problems, particularly in older adults. Careful assessment is important for determining appropriate management.
Dr Sen’s PhD research focused on aortic stenosis, specifically developing and validating prognostic phenotypes using machine learning and clinical data. This work, published in multiple high impact factor journals such as JACC: Cardiovascular Imaging, examined how different patient characteristics influence outcomes and may inform treatment decisions.
Dr Sen provides evidence‑based, patient‑centred care that balances the use of modern interventions with the prudence of careful observation, ensuring that each individual receives the right treatment at the right time.
Assessment and Monitoring
Assessment of valvular heart disease typically involves a detailed history, physical examination, and cardiac imaging. Dr Sen uses advanced echocardiographic techniques to characterise valve function and assess how it affects the heart. All findings are discussed in detail to help patients understand their condition and management options.
Comprehensive echocardiographic assessment (including a tailored valvular protocol)
Exercise stress testing or Advanced Echocardiography
Integration of clinical and imaging data for decision-making
Collaboration with interventional cardiologists and cardiac surgeons when required
Valve Intervention might not be immediately necessary
While there are situations when urgent valve intervention is required, not every valve abnormality that is detected requires urgent surgery or catheter‑based repair/replacement. Close observation, often termed “watchful waiting” or “conservative management”, might be the safest and most appropriate course when symptoms are absent or minimal, and where imaging shows stable disease.
A conservative approach allows us to:
Monitor disease progression with periodic imaging and regular clinical review.
Avoid unnecessary procedural risks when the benefit is uncertain.
Tailor timing of any future intervention to the moment it is truly advantageous for the individual’s overall health and quality of life.
Optimal timing of intervention, the ideal management strategy and personalised cardiovascular care is an area of active research worldwide. Decisions about whether to proceed with an intervention are always made collaboratively after reviewing the full clinical picture and discussing the patient’s personal goals and preferences.