A leaky heart valve — also known as heart valve regurgitation or valve insufficiency — is a heart valve that does not close properly. As the heart pumps, some blood leaks back through the valve.

The potential causes of a leaky heart valve range from infections to autoimmune diseases. Some people have no signs that they have the condition, while others experience symptoms such as shortness of breath and dizziness.

Doctors treat leaky heart valve with medications, surgery, or a combination of the two.

Read on to learn more about leaky heart valves, including the symptoms, causes, and treatment.

A diagram of the heart and its four valves.Share on Pinterest
Design by Diego Sabogal

The heart has four valves. Each valve must open and close at the right times to pump oxygen-rich blood around the body. The valves have flaps that keep blood flowing in one direction, preventing it from flowing backward.

However, a leaky heart valve does not close properly, which can allow some blood to flow back through it. This is a type of valvular disease.

Valvular disease can affect any of the four heart valves. These are:

  • Tricuspid valve: This has three flaps and sits between the right atrium and right ventricle.
  • Mitral valve: This consists of two flaps and sits between the left atrium and left ventricle.
  • Pulmonary valve: This has three flaps and sits between the right ventricle and the pulmonary artery, which is the vessel that carries blood to the lungs.
  • Aortic valve: This consists of three flaps and sits between the left ventricle and the aorta, which is the vessel that carries blood to the rest of the body.

The aortic valve is the most common valve to leak.

A leaky heart valve is potentially serious. A leaky heart valve places strain on the heart, as it makes it more difficult for a person’s heart to pump blood. It can also prevent the rest of the body’s organs and tissues from receiving enough blood.

However, a leaky heart valve can be mild or severe. Some people do not experience any symptoms and may not know they have a leaky heart valve. Others may develop symptoms over time.

If the condition is severe, a person may experience heart failure or a sudden heart attack.

People who develop heart valve disease gradually may not experience any symptoms for a long time.

According to the Centers for Disease Control and Prevention (CDC), people who develop sudden heart valve disease may experience one or more of the following symptoms:

Several factors can cause a leaky heart valve. The possible causes vary depending on the affected valve.

Some common causes of aortic valve regurgitation include:

Possible causes of mitral valve regurgitation include:

  • wear and tear due to aging
  • damage due to high blood pressure
  • cardiomyopathy, a stretching, thickening, or stiffening of the walls of the heart
  • endocarditis, an infection of the heart’s inner lining
  • congenital heart disease, which is a heart condition that a person is born with

Possible causes of tricuspid valve regurgitation include:

Possible causes of pulmonary valve regurgitation include:

  • pulmonary hypertension
  • infective endocarditis
  • complications after surgery to repair congenital heart defects
  • carcinoid syndrome, which is a set of symptoms associated with having carcinoid tumors
  • rheumatic fever
  • complications after catheterization for a medical procedure

This is not a comprehensive list of all possible causes of valvular disease. For a diagnosis, a person should speak with a cardiologist.

To diagnose a leaky heart valve, doctors review a person’s medical history and perform a physical examination. This involves checking the person’s symptoms and assessing their risk factors, such as whether the condition runs in the family.

Doctors may also perform one or more of the following diagnostic tests on the heart:

  • Echocardiogram: This uses sound waves to create moving pictures of the heart.
  • Electrocardiogram: This detects and records the heart’s electrical activity.
  • Chest X-ray: This involves using radiation to take pictures of the structures in and around the chest.
  • Stress test: This involves a person walking on a treadmill or cycling on a stationary bike to test how well the heart works under physical stress.

People who do not experience symptoms of leaky heart valve do not require treatment. However, a person may need treatment if the condition has the potential to reduce the quality or length of their life.

Lifestyle changes and medication may be enough for people with mild symptoms. In more advanced cases, doctors may recommend one of two types of surgery: valve repair or valve replacement.

Valve repair

A doctor may suggest valve repair if a person has new symptoms, or if their existing symptoms worsen. There are several ways a surgeon can do this, such as:

  • fixing valve flaps
  • repairing supporting structures
  • tightening or strengthening the base of the valve
  • inserting a stent to prevent leakage
  • for mitral valve leakage, implanting a device

Valve replacement

A doctor may recommend valve replacement if valve repair is not an option.

Replacement heart valves can be biological, meaning they consist of human or animal tissue, or mechanical. Biological valves do not last as long, but mechanical valves require a person to take blood thinning medication for the rest of their life.

Surgeons can implant valves by opening the person’s chest cavity. Alternatively, transcatheter aortic valve replacement (TAVR) is a minimally invasive technique that specifically helps with aortic valve leaking.

To perform TAVR, a surgeon inserts the new valve into the old one. They can do this using a catheter with a balloon, which carries the replacement valve to the correct place in the heart. Another method involves making a minimally invasive incision in the chest and entering the heart through an artery or left ventricle.

A person with leaky heart valve can take measures to support their health. The American College of Cardiology offers some key tips for managing the condition. These include:

  • taking all medications according to a doctor’s instructions
  • following their exercise recommendations
  • maintaining muscle mass
  • limiting salt intake to prevent fluid retention
  • eating a heart-healthy diet, with plenty of fruits and vegetables and few saturated fats
  • keeping blood pressure under control
  • talking with a doctor about any changes in symptoms or body weight

People should not engage in vigorous exercise without consulting a doctor first.

If a person gains 2–3 pounds (lb) overnight or gains 5 lb in a week, they should speak with a doctor as soon as possible.

Below are some answers to common questions concerning leaky heart valves.

Can a leaky heart valve fix itself?

A leaky heart valve cannot repair itself. The only way of fixing a heart valve is through valve repair or replacement surgery. Sometimes, a leak that occurs due to an infection responds to antibiotic treatment.

Other medications and lifestyle changes also do not fix a leaky heart valve. However, they can keep symptoms under control and prevent further complications.

Can people with a leaky heart valve live a long life?

The outlook for a person with leaky heart valve depends on their individual circumstances. A person’s age, overall health, symptom severity, and response to treatment all influence their life expectancy.

Untreated valvular disease has a poor outlook and may lead to serious complications such as stroke, blood clots, liver damage, heart failure, and heart attack. Therefore, anyone with concerns about their heart should speak with a doctor as soon as possible.

A person has a leaky heart valve if one or more of the heart’s valves does not close properly. This can place strain on the heart as it attempts to pump blood around the body. It can also allow some blood to flow backward, depriving organs of blood and oxygen.

Some people experience serious symptoms due to a leaky heart valve, while others do not know they have the condition. People without symptoms may not require treatment, while those with milder symptoms may respond well to medications and lifestyle changes.

People with moderate or severe symptoms may need surgery to repair or replace the heart valve.