Talking about heart problems at the dinner table

The question came during a large dinner with friends:

One friend’s mother, a woman in her 80s, had aortic stenosis, one of the most common and serious heart valve conditions.

“Should she get this addressed? Will she feel better?” my friend asked across the table. “Her cardiologist says she would be a good candidate for the procedure.”

I asked, “Does she have any other conditions or circumstances that you’re worried about?”

None, she said.

“Yes, then I think this is definitely worth addressing,” I told her emphatically. “Even if it’s hard to imagine going through a procedure, this will help her feel much better.”

The heart has four valves — one-way doors that only allow the blood to move forward.

The aortic valve sits between the heart and the aorta, which is the major blood vessel that channels blood from the heart to the rest of the body. Aortic stenosis is when that valve gradually thickens and obstructs, often seen with aging. To overcome the narrowing, the heart has to work harder to pump blood, which causes highly alarming symptoms.

My friend was worried that her mother was beginning to experience some of these symptoms, such as chest discomfort, shortness of breath, and light-headedness, that indicate the condition is worsening.

Treating aortic stenosis can be complicated, but that wasn’t the case for my friend’s mother. Her physician had already deemed her a safe candidate for a surgery to repair the valve.

Once you surgically repair the valve, the heart will immediately pump easier, and blood will flow better. She will live longer and feel better.

Without treatment, she would have likely died within a few years.

I think back to this dinner table often as I think about our patients’ barriers to finding the care they need.

As physicians, we often think the greatest barrier to helping our patients is not knowing what to do or not having a good option. We are constantly searching for new drugs, procedures, or strategies to cure highly complex conditions.

But in many cases, we know the answers. We have drugs and procedures. We just have not been able to reach people in a way that they clearly understand.

Sometimes the patients do not fully comprehend their own conditions or the urgency of their symptoms. Sometimes the needed procedure is complicated and intimidating to families. Other times, we struggle with how to convey the importance of a treatment or of choosing the “right” treatment without causing excessive worry or decision paralysis.

Moreover, patients don’t always get the opportunity to ask questions over a dinner conversation as directly as my friend. And decoding medical jargon alone can be overwhelming for patients and their families and may leave them even more uncertain about what happens next.

Back to the dinner table.

Several weeks later, my friend’s mother had the surgery and went home a few days later. At our next dinner gathering, she said her mother was no longer short of breath while walking and could not remember having felt so uncertain about all of this.

Jason Han is a cardiac surgery resident at a Philadelphia hospital and contributor to The Inquirer’s Health section.