Awareness Survey on Doctor-Patient Communication Regarding Valvular Heart Disease in Japan

Edwards Lifesciences (headquartered in Shinjuku-ku, Tokyo; Miyuki Okushi, Representative Director and President; hereinafter 'Edwards'), a company dedicated to developing treatment technologies for patients battling cardiovascular disease, conducted an awareness survey (hereinafter 'this survey') targeting a total of 1,690 individuals aged 65 and older and cardiovascular physicians regarding their understanding of heart disease and communication during medical examinations. [Survey Results Highlights] (Excerpts) - While interest in the 'heart' is high, only about 40% understand that symptoms of valvular heart disease are 'easily mistaken for aging.' - Less than half of those with symptoms such as shortness of breath seek medical attention. 'Thinking it is temporary' or 'blaming it on age' are barriers. - In terms of explanation and understanding during consultations, 37% of patients and 77% of physicians feel difficulties. Ingenuity is important for mutual understanding. In Japan, where the population is aging, the importance of preventive medicine is increasing for the extension of healthy life expectancy and the prevention of severe illness. In particular, the number of patients with heart failure continues to increase, and an appropriate response to the underlying diseases is required. 'Valvular heart disease,' one of the main causes of heart failure, has an increasing incidence rate as people age. On the other hand, its main symptoms—'shortness of breath,' 'palpitations,' and 'chest pain'—can be difficult to distinguish from physical changes associated with aging, making delayed medical consultation a challenge. Also, when considering treatment policies, information sharing and understanding between physicians and patients in the clinical setting are important because there are multiple treatment options. 'Interest in the 'heart' is high, but understanding of the 'difficulty of self-awareness' is insufficient.' When asking all participants, 'What part of your body do you think is at high risk if you get sick?', the most common answer was the 'heart' (37%) (Figure 1). In addition, regarding valvular heart disease, 96% of respondents answered that they knew about it, including those who said they 'had heard the name,' indicating that awareness of the disease name is extremely high (Figure 2). On the other hand, as characteristics of valvular heart disease, only 42% answered that it is 'easily mistaken for symptoms of aging,' and only 35% answered that 'there are cases where symptoms are not noticed because activity levels are unconsciously reduced' (Figure 3). Although the disease name has permeated, the reality that valvular heart disease is characterized by 'symptoms that are difficult to notice' has not been sufficiently understood, which was highlighted. 'Less than half seek medical consultation even if they have symptoms.' Among those who have felt symptoms such as shortness of breath, palpitations, or chest pain, only 50% or less visited a medical institution due to those symptoms (Figure 4). Reasons for not visiting included 'I thought it was temporary' and 'I thought it was due to age' (Figure 5). This suggests that there may be differences in judgment leading to medical consultation depending on how symptoms are perceived. 'Difficulty in information transmission observed in scenes of conveying symptoms.' The survey also revealed communication issues in medical examination settings. The percentage of respondents who answered that they 'have felt difficulty in conveying symptoms' was 33% for patients and 56% for cardiovascular physicians (Figures 6 and 7). On the patient side, 'could not explain symptoms well in words' (21%) was the most common, and on the physician side, 'wording and expressions (of the patient) were ambiguous, and it was difficult to obtain medically accurate information' (33%) was frequently cited. In situations where symptoms are conveyed, it was suggested that both the patient's ingenuity to organize and convey their symptoms and the physician's ingenuity to confirm and organize that content are important. 'Difficulty in reconciling treatment explanation and understanding.' Regarding the question about the explanation of treatment policy, the percentage of respondents who answered that they 'have felt difficulty in treatment explanation' was 37% for patients and 77% for physicians (Figures 8 and 9). On the patient side, 'could not grasp how serious my condition was' (22%) was frequent, and on the physician side, 'it was difficult for elderly patients to listen or remember, and it was difficult to confirm understanding' (44%) was frequently cited. It was found that both parties feel difficulty even at the stage of understanding the medical condition and considering the treatment policy, indicating the necessity of ingenuity to support mutual understanding. 'Creating an environment to support information sharing for satisfactory treatment consideration.' Treatment policies for valvular heart disease are considered based on each patient's age, comorbidities, life background, and hopes for life after treatment. In addition to the comprehensive judgment by a 'valvular disease team' consisting of cardiovascular physicians, cardiac surgeons, etc., it is important for patients to understand their own situation and participate in decision-making after being convinced. The results of this survey suggested that there are difficulties from both the physician and patient perspectives in communication, which plays an important role in symptom sharing and treatment consideration, and that ingenuity and support are necessary for better treatment selection. As a company providing medical devices in the field of structural heart disease, centered on valvular heart disease treatment, Edwards will continue to work to help promote the correct understanding of the disease and better communication between physicians and patients in addition to the advancement of medical technology. [Survey Overview] Survey Subject: Edwards Lifesciences Survey Content: Valvular heart disease and doctor-patient communication Survey Targets: Nationwide residents 65 years or older, cardiovascular physicians Valid Responses: 1620 residents, 70 cardiovascular physicians, 1690 total Survey Period: November 15, 2025 to December 15, 2025 Survey Method: Internet survey Survey Outsourcing Partner: Dentsu Macromill Insight, Inc. About Edwards Lifesciences (https://www.edwards.com/jp) Edwards Lifesciences is a global leader in patient-focused medical innovation in the field of structural heart disease. Driven by a passion to help patients, we are working to realize a healthier life for patients through partnerships with medical professionals and stakeholders at healthcare sites around the world. As of March 2026, the Japanese subsidiary, Edwards Lifesciences, has locations in 8 cities nationwide and provides medical technology centered on valvular heart disease treatment products. About Valvular Heart Disease Valvular heart disease is a disease in which the heart valves degenerate or calcify due to aging as a main cause, and it is said that about 1 in 10 people over 65 are affected. This causes blood flow to stagnate or backflow, placing a burden on the heart, eventually leading to heart failure. In the total population of Japan, it is estimated that there are approximately 1.4 million potential patients aged 65-74 and approximately 2.6 million potential patients aged 75 or older. Among the 4 valves in the heart (tricuspid valve, pulmonary valve, mitral valve, aortic valve), abnormalities are often seen in the aortic valve and mitral valve. Early detection and appropriate treatment of valvular heart disease lead to the prevention of heart failure, so its social importance is increasing in order to prevent a 'heart failure pandemic.' However, the main symptoms are 'shortness of breath' and 'palpitations,' and because it is difficult to distinguish from changes due to aging, it is often overlooked as 'because of age' even if there are symptoms. Furthermore, elderly people tend to unconsciously reduce their activity level, and the decline in activity level in daily life makes it even more difficult to realize symptoms, so there are many cases where discovery is delayed.

While it is difficult to realize symptoms, it is possible to notice abnormalities during a medical examination by a physician. If you perform auscultation, you can grasp the possibility of valvular heart disease from a characteristic sound called a heart murmur. A definitive diagnosis is made by confirming the movement of the valves and blood flow in detail using an echocardiogram, which can be done in a short time without pain. If you have any symptoms that concern you, it is important to have a physician listen to your heart, and if you are pointed out to have a heart murmur, consult a cardiovascular physician early. If it is mild to moderate, conservative treatment that suppresses symptoms with oral medication is performed. However, because it cannot stop the progression of the disease, surgery is necessary at an appropriate timing when it progresses to severe or higher while continuing regular examinations. There are two types of surgery: 'surgical treatment' and 'catheter treatment.' Surgical treatment is performed by 'open-heart surgery,' which opens the chest and temporarily stops the heart using a heart-lung machine. This treatment is performed based on procedures established over many years, and in recent years, minimally invasive surgery (MICS), which is performed with a small incision, has become widespread, leading to the reduction of the burden on patients. On the other hand, catheter treatment is a method of placing an artificial valve using a catheter (tube) without opening the chest and without stopping the heart. It is characterized by less burden on the patient's body and a relatively short hospital stay. Representative catheter treatment methods for valvular disease include TAVI (transcatheter aortic valve implantation) and TEER (transcatheter edge-to-edge repair). It is attracting attention as an option applicable to the elderly and high-risk patients. For detailed information on valvular heart disease, please visit the 'Valvular Disease Site' (https://www.benmakusho.jp/). Notes: 1) Nkomo VT, et al: Lancet. 2006;368:1005-11. 2) Statistics Bureau of the Ministry of Internal Affairs and Communications. Summary of Population Estimates, April 2020 Report (November 2019 Final Values). Available from: https://www.stat.go.jp/data/jinsui/pdf/202004.pdf (Accessed: February 2024)