In a healthy heart, blood flows in only one direction. The four valves of the heart prevent blood from flowing backward. But a leaky heart valve, or heart valve regurgitation, causes a backflow of blood.

If the leak is severe, it may cause blood clots, heart failure, heart arrhythmias, and other serious complications.

The effects that a leaky valve has on the heart depend on many factors — most notably, which valve is leaking and how significant the leak is. In many cases, a leaky valve is a complication of another heart condition that requires treatment.

When the leak is serious enough to affect a person’s heart health, doctors may recommend replacing the valve if the person is healthy enough for surgery. People who undergo heart valve replacement have a good long-term outlook.

This article provides an overview of the different types of leaky valves that may affect the heart.

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The heart has four valves. These ensure blood flows in the right direction in each chamber of the heart and into and out of the heart. The four heart valves are the:

  • pulmonic valve
  • tricuspid valve
  • mitral valve
  • aortic valve

Each valve closes using leaflets — flaps of tissue — to fully close. When leaflets do not close all the way or close too slowly, it can cause blood to flow in the wrong direction. This affects blood flow in the heart itself, as well as the whole body.

In some cases, a leaky heart valve can be a relatively minor, benign condition that does not require treatment. However, in other cases, the condition can progress to heart failure if a person does not get treatment.

Learn more about the life expectancy of someone with a leaky heart valve.

What causes a leaky valve in the heart?

Many different conditions can cause a leaky valve. The causes may differ depending on which valve is leaking.

Some of these conditions may be present from birth.

Also, certain surgical procedures, such as surgical valvotomy and balloon valvuloplasty, may cause valve disease.

Learn more about the causes of leaky heart valves.

The following risk factors can increase a person’s likelihood of developing valve disease:

  • Mitral valve prolapse: Better known as a heart murmur, mitral valve prolapse sometimes worsens or causes a leaky mitral valve.
  • Radiation therapy: Exposure to radiation earlier in life can increase the risk of heart valve disease.
  • Calcification: Over time, calcium deposits can accumulate in the valves, causing them to become narrowed or damaged.
  • Infections: Infections, such as endocarditis and rheumatic fever, may damage heart valves.
  • Heart disease: Certain diseases of the heart, such as cardiomyopathy, may also affect the heart valves.

Valve regurgitation may not always cause symptoms. When it does, some symptoms a person may notice include:

Tricuspid regurgitation affects the tricuspid valve, which allows blood to flow from the right atrium to the right ventricle.

A leaky tricuspid valve can cause backflow into the right atrium. The condition is either primary, where there is direct damage to the valve, or secondary.

It can range from mild to severe. While mild cases — when the person is asymptomatic — may require ongoing monitoring only, more severe cases may need treatment. Asymptomatic means that the disease does not lead to any symptoms in a person.

Severe cases may lead to right heart failure. However, the proper time for surgery, if necessary, remains controversial.

Although many factors can influence survival, typically, the long-term outlook for a person with tricuspid regurgitation is poor.

Mitral regurgitation affects the mitral valve, which separates the left atrium from the left ventricle. If the mitral valve leaks, it can cause blood to flow back to the left atrium.

A person’s risk of developing mitral valve regurgitation increases with age. As with other types, mitral valve regurgitation may not always cause symptoms.

This condition increases the risk of death and complications, but with treatment, long-term outcomes greatly improve.

A 2018 study found that earlier surgical interventions may mean that people with mitral valve regurgitation can expect to have a typical life expectancy. However, further research into the incidence of arrhythmias or heartbeat irregularities in this population would be beneficial.

Mitral valve regurgitation is often a complication of mitral valve prolapse. This occurs when the leaflets become floppy and do not shut tightly.

The pulmonic valve opens to allow blood to flow into the lungs. When it leaks, blood flows backward, leading to a delay in blood flow to the lungs.

As the disease advances, a person may develop symptoms, such as an inability to exercise.

An underlying heart issue may cause symptoms, rather than the leaking valve. Due to this, doctors may prioritize managing the underlying condition.

Treatment of other heart conditions can lead to pulmonary regurgitation. An example of this is when doctors use surgery to repair tetralogy of Fallot — a condition that entails four defects in the heart. The doctor may monitor a person after surgery for any symptoms.

Medical professionals currently disagree about the best time to perform surgery to replace this valve. Doctors reserve valve replacement surgery for people experiencing severe symptoms. However, surgery can improve a person’s outcome, especially in the earlier stages of the disease.

The aortic valve allows blood to flow from the heart into the aorta, an artery that transports blood throughout the body. When it leaks, this delays blood flow to the body.

There are two types of aortic regurgitation, acute and chronic. This condition seems to affect males more than females.

The prevalence of aortic regurgitation increases with age, and it more commonly affects people over the age of 50. Other conditions that a person has may increase their risk of aortic regurgitation.

Advanced age is an important factor that may influence survival and surgical risk, among other factors.

Surgery can help improve a person’s outlook. A 2021 study found that the median survival after aortic valve replacement was more than 15 years in lower-risk people under the age of 70. However, median survival was also substantial in older people.

A leaky valve can also be a symptom of underlying heart disease. This can include aortic stenosis — a buildup of deposits that narrow the aortic valve.

Treatment depends on the severity of the leaky valve and a person’s overall health. Older adults and people who are frail or very sick may be unable to have surgery.

The treatment options include:

  • Surgery: To repair or replace the affected valve.
  • Cardiac rehabilitation: After surgery, this can help people regain independence.
  • Medications: For example:
    • blood thinners to reduce the risk of blood clots
    • beta-blockers to reduce the risk of heart arrhythmias
    • digoxin (Cardoxin), or other medications that treat heart failure
  • Percutaneous or catheter-based procedures: This less invasive treatment type may be available for those unable to undergo surgery

The doctor may also recommend various lifestyle changes, such as maintaining a healthy diet.

Learn more about how lifestyle changes can help prevent leaky heart valves.

A leaky valve in the heart can affect heart health and may eventually lead to other health complications. It can also make exercising more difficult, affect a person’s energy levels, and cause a person to feel less healthy.

In many cases, a leaky valve is treatable with surgery. Doctors may also address the underlying causes of the leaky valve. A leaky valve is often a sign of heart disease.

A cardiologist can help diagnose heart valve disease and recommend treatment options on the basis of a person’s health and treatment goals.