Key takeaways

  • Heart valve disease happens when one of your heart’s four valves doesn’t open fully (stenosis) or close properly (regurgitation or prolapse), forcing your heart to work harder to pump blood.
  • Symptoms can include fatigue, shortness of breath, chest pain, swelling in your legs or abdomen, and heart palpitations. Some people may not notice symptoms at all, but monitoring is still important.
  • Treatment depends on severity and may include medications to manage symptoms and complications, surgical valve repair or replacement, or minimally invasive procedures like transcatheter aortic valve replacement (TAVR).

Heart disease and heart valve disease are closely linked terms, but they aren’t always interchangeable.

Heart disease, also known as cardiovascular disease, is a broad term for many medical conditions affecting your heart and blood vessels. When heart problems specifically affect a heart valve, this is referred to as “heart valve disease” or “valvular heart disease.”

Your heart has four valves. You have a valve between each upper and lower chamber (your atriums and ventricles), and a valve from each ventricle into a main artery (your pulmonary artery and your aorta).

These valves act as one-way doors, ensuring that blood flows through your heart efficiently and in the correct direction. When a heart valve doesn’t function correctly, your heart has to work harder to meet the needs of your body.

Approximately 2.5% of adults in the United States live with a heart valve disease, and these conditions are more common in older adults.

Heart valve disease can appear in different ways. It affects how a heart valve opens or closes, and it’s possible to have multiple valves affected or more than one type of valve disease at the same time.

Stenosis

Stenosis limits how wide a heart valve opens. In this type of valve disease, the valve flaps become stiffer. They don’t open as wide as they should, reducing the amount of blood that can flow through. As the opening narrows, your heart pumps harder to compensate. This can strain your heart and, over time, lead to concentric hypertrophy, a certain type of heart wall thickening.

Atresia

Atresia is a rare condition present at birth (congenital). If you’ve been diagnosed with this type of heart valve disease, it means a valve in your heart didn’t form correctly. Instead of opening as it should, the valve didn’t form properly, and tissue blocks blood flow.

Regurgitation

When valve flaps don’t close properly, they can allow blood to leak backward. Also known as “leaky valve,” this type of heart valve disease causes increased blood volume in the affected heart chamber. Over time, excess pressure and volume in a chamber can cause it to stretch and dilate, and in some cases, thicken.

Prolapse

Prolapse is often lumped into the same category as regurgitation because it can cause blood to flow backward through a valve opening. Prolapsed valve flaps are limp or stretchy, which allows them to pull back into the chamber when your heart beats.

The most common is mitral valve prolapse, in which the mitral valve (the valve between the left heart chambers) doesn’t close properly and bulges backward into the left atrium during a heartbeat.

Heart valve disease naming

In heart valve disease, your formal diagnosis usually consists of the valve involved and the type of problem. For example:

  • Aortic stenosis: Narrowed aortic valve.
  • Mitral regurgitation: Leaky mitral valve.
  • Pulmonary stenosis: Narrowed pulmonary valve.

In some cases, the cause is also included in the diagnostic term, such as:

  • Rheumatic mitral stenosis: Mitral stenosis caused by rheumatic fever.
  • Degenerative aortic stenosis: Aortic stenosis caused by age-related changes and progressive calcification.

When your heart can’t pump efficiently, problems can develop throughout your body.

Reduced forward blood flow means your tissues and organs get less oxygen-rich blood. Backward blood flow can raise pressure in blood vessels, especially in the lungs.

This can lead to:

  • fatigue
  • weakness
  • fainting or dizziness
  • shortness of breath
  • disrupted sleep due to difficulty breathing while lying flat
  • fluid buildup in the lungs (pulmonary edema)

Overall, inefficient pumping can increase pressure in blood vessels throughout your body and force fluid into surrounding tissue.

You might notice:

  • swelling in your legs or ankles (edema)
  • abdominal swelling

In addition to symptoms in other parts of your body, heart valve disease can cause heart-specific symptoms. Many people experience chest pain or heart palpitations as the heart muscle changes over time.

Heart valve disease symptoms can range from mild to severe. Some people with heart disease may feel fine, but the condition can affect the heart if it’s severe, progresses, or worsens.

For some people, heart valve disease is congenital (present at birth). For others, it develops later in life due to age-related changes, ongoing heart strain, or damage.

Many different medical conditions can cause heart valve disease, including:

  • heart attack
  • high blood pressure
  • thoracic aortic aneurysm (bulging of the aorta in the chest)
  • lupus
  • Marfan syndrome (a genetic connective tissue disorder)
  • age-related calcification
  • infective endocarditis (a heart valve infection)
  • rheumatic fever (an inflammatory complication of untreated or poorly treated strep throat)
  • Ebstein’s anomaly (a congenital heart defect affecting the tricuspid vavle)
  • mediastinal radiation therapy (radiation treatment to the chest area)

Many cases of heart valve disease are found during a routine exam when your doctor listens to your heart with a stethoscope and hears a murmur. Valve problems often create distinctive sound patterns.

For some people, symptoms like shortness of breath, chest pain, or fainting lead to the diagnosis.

When your doctor suspects heart valve disease, depending on the symptoms and suspected cause, they may order some or several of the following tests:

  • Echocardiography: An ultrasound of the heart with Doppler imaging to track blood flow.
  • Electrocardiogram (ECG): Measures the electrical signals in the heart.
  • Echocardiogram: Checks heart pumping function and evaluates heart valve disease and severity.
  • Computed tomography (CT) scan: Uses X-rays to create detailed cross-sectional images of the heart.
  • Cardiac magnetic resonance imaging (MRI): Provides a layered, detailed image of the heart in complex cases.
  • Cardiac stress test: Checks heart function, usually through exercise or chemically induced stress.

Treatment for heart valve disease depends on the underlying cause, your overall health, and how much it’s affecting the heart. Your doctor might recommend:

  • Medications to help manage symptoms, prevent blood clots, control blood pressure or heart rhythm, and manage issues like heart failure.
  • Surgical repair or replacement if the valve is moderately or severely damaged.
  • Minimally invasive procedures, such as transcatheter aortic valve replacement (TAVR), where a doctor threads a new valve through a catheter from your leg or chest artery, are often a good fit for older adults or those with higher surgical risks.
  • Regular follow-up with a cardiologist to monitor your heart and valve function.

Medications can’t fix a damaged valve, but they can help manage symptoms and lower the risk of complications like heart failure or blood clots.

Doctors and your cardiovascular team will decide on the best approach based on your specific heart valve problem, underlying cause, surgical risk, and age.

The decision involves choosing between repair or replacement. If replacement is needed, you’ll discuss mechanical valves (very durable but usually require blood thinners) versus bioprosthetic tissue valves (no long-term blood thinners but might need replacing after 10 to 20 years).

Talk with your care team about which treatment option is best for you and your needs.

Heart valve disease isn’t always preventable, but focusing on your overall heart health can help lower your risk.

Many everyday factors that raise heart disease risk can also affect your heart valves. You can support your valve health with these proven heart-healthy habits:

  • managing blood pressure
  • not smoking
  • managing cholesterol
  • maintaining healthy blood sugar
  • eating a heart-healthy diet (low in saturated fats, added sugar, and processed foods)
  • getting regular exercise
  • maintaining a healthy weight
  • treating infections like strep throat as soon as possible
  • taking care of your dental health
  • seeing your doctor regularly for checkups

Heart valve disease is a type of heart disease. It happens when a valve doesn’t open fully or close properly. Some people are born with it, while others develop it over time from heart damage and strain.

If you have heart valve disease, treatment depends on how your heart is functioning and your overall health. Your doctor might prescribe medications to manage symptoms, but surgery to repair or replace the valve may be needed in more severe cases.