If any of the heart’s valves are damaged or diseased, it is referred to as valvular heart disease. This damage can mean the valves fail to close properly, causing blood to leak back through them. Or it could mean the valves narrow and stiffen, decreasing blood flow through the heart.

Roughly 2.5% of people in the United States have valvular heart disease. It is more common in older adults.

This article outlines valvular heart disease, its symptoms, causes, risk factors, treatment options, and more.

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Any disease or damage that affects one of the heart’s valves is known as valvular heart disease.

Any valve in the heart can become diseased, but it is most common in the mitral and aortic valves.

Diseased valves may fail to close completely, which can cause blood to leak back into the chamber it came from. If this happens, not enough blood flows through the heart. This is called regurgitation.

Diseased valves may also become narrow and stiff. This can cause the valve to open incompletely, preventing blood from flowing through properly. This is called stenosis.

The heart has four chambers. They are:

  • the right atrium
  • the left atrium
  • the right ventricle
  • the left ventricle

The heart also has four valves. These valves open and close to allow blood to flow through the heart. The four valves are:

  • The mitral valve: This is also known as the bicuspid valve. It allows blood to flow from the left atrium to the left ventricle.
  • The tricuspid valve: This valve allows blood to flow from the right atrium to the right ventricle.
  • The aortic valve: This valve allows blood to flow from the left ventricle to the aorta. The aorta is the main artery that carries oxygenated blood from the heart to the rest of the body.
  • The pulmonary valve: This valve allows blood to flow from the right ventricle into the pulmonary artery. The pulmonary artery carries deoxygenated blood from the right ventricle to the lungs.

Learn more about heart valves here.

Common types of valvular heart disease include:

  • Aortic valve disease: There are two types of aortic valve disease. Aortic stenosis occurs when the opening of the aortic valve is narrower than it should be, restricting the flow of blood to the aorta. Aortic regurgitation occurs when some of the blood leaks back into the left ventricle because the aortic valve does not close properly.
  • Rheumatic heart disease: This is a systemic immune condition that is a complication of rheumatic fever. Rheumatic fever is an inflammatory disease that may affect the connective tissues in the heart. Rheumatic heart disease occurs when rheumatic fever permanently damages the valves of the heart.
  • Bicuspid aortic valve: A bicuspid aortic valve is a hereditary heart defect that occurs when the aortic valve contains two flaps instead of the usual three. This can make it difficult for the heart to pump blood into the aorta.

Learn more about common heart valve disorders here.

Different valvular heart diseases can develop quickly or over a longer period. If valvular heart disease develops slowly, a person may not experience symptoms until the disease becomes advanced.

If a person’s disease develops more rapidly, a person may experience various symptoms.

Common symptoms of valvular heart disease include:

Common causes of valvular heart disease include:

  • Rheumatic disease: This occurs due to an infection from the bacteria that cause strep throat. If a person does not treat this infection with antibiotics, it can cause scarring of the heart valves.
  • Endocarditis: Endocarditis occurs when a severe blood infection causes inflammation of the inner heart lining. This infection may settle on the heart’s valves and damage them. A person may also contract endocarditis through intravenous drug use.
  • Congenital heart valve diseases: These are malformations of the heart valves that are present at birth. A bicuspid aortic valve is the most common form of congenital heart valve disease.
  • Heart disease: Other types of heart disease can lead to damaged valves. These include heart failure, atherosclerosis, thoracic aortic aneurysm, high blood pressure, and heart attack.

Other conditions that may cause valvular heart disease include:

The aging process can also cause calcium deposits on the heart’s valves. This can cause them to stiffen or thicken, which makes them less efficient.

There are several risk factors for valvular heart disease. These include:

  • Age: As a person gets older, their risk of valvular heart disease increases.
  • Family history: Some heart issues can run in families. If a person has relatives with mitral valve prolapse or bicuspid aortic valve problems, they may have an increased risk of valvular heart disease. A family history of early coronary heart disease can also increase a person’s chances of developing valvular heart disease.
  • Lifestyle: Certain lifestyle factors can raise a person’s risk of other types of heart diseases as well as valvular heart disease. Lifestyle risk factors include a lack of physical activity, an unhealthy diet, smoking, and obesity.
  • Medical devices: Some medical devices, such as defibrillators and pacemakers, may rub against certain valves. This can create scar tissue and may stimulate the heart to beat out of rhythm. This can also stretch a heart valve, raising the risk of valvular heart diseases.
  • Other health conditions: Health conditions such as high blood pressure, diabetes, autoimmune disorders, and heart conditions can increase a person’s risk of valvular heart disease.
  • Radiation treatment: Radiation treatment for cancers can cause heart valves to thicken and narrow.
  • Sex: Males are more likely than females to develop valvular heart disease.

To diagnose valvular heart disease, a doctor will begin by listening to the heart using a stethoscope. If they hear a heart murmur when listening to a person’s heartbeat, may it may suggest valvular heart disease. However, a heart murmur can also be benign and occur without a structural problem with the heart.

A number of factors can help a doctor determine which valve is creating the murmur and whether the issue is regurgitation or stenosis. These factors include:

  • the location of the murmur
  • how the murmur sounds
  • the rhythm of the murmur

A doctor may also use echocardiography to confirm a diagnosis. This test uses high frequency waves to create a live image of the heart. A doctor can look at these results to see if the valves are working correctly.

If a person’s valvular heart disease is not too severe, they may manage it with medications that help treat their symptoms.

If damage to the valve is more severe and causes serious symptoms, a person may require surgery.

The type of surgery will depend on which valve is involved and what is causing the disease. In some instances, a surgeon may replace the entire valve.

If a person has a damaged heart valve, it may impair the heart’s ability to pump blood around the body. This can cause various complications.

If the heart does not receive enough blood, it can become weak, which can lead to heart failure.

Damaged heart valves may also cause a person to develop arrhythmia, which is an irregular heartbeat.

Valvular heart disease may also cause a person to develop lung problems. One potential issue is a buildup of blood in a person’s lungs. This can cause high blood pressure or an accumulation of fluid in the lungs. Both of these issues may lead to severe breathing difficulties.

If a person’s heart valves become narrow or leaky, the heart can often compensate for this for years and sometimes decades.

The heart may then grow thicker and become enlarged. If the heart then has to work harder over a long period, it cannot return to its normal size, which can cause the symptoms of valvular heart disease to worsen.

Valvular heart disease can cause the heart muscle to thicken and lose elasticity. It may also cause the ventricles to wear out, weakening the heart.

Symptoms of a weakened heart may only arise during strenuous physical exercise. However, over time, the symptoms may occur at rest. If the heart becomes very weak, it may cause life threatening heart failure.

Heart conditions, such as coronary artery disease and irregular heartbeats, may also worsen the symptoms of valvular heart disease. And heart attacks may worsen heart valve damage, leading to acute heart failure.

Valvular heart disease is an umbrella term for any disease that causes damage to one of the heart’s valves.

These conditions can cause regurgitation, where valves fail to close properly. This can cause blood to leak back into the chamber it came from.

Valvular heart disease can also cause stenosis, where valves become narrow and stiff. This can prevent the right amount of blood from flowing through the valve.

Causes of valvular heart disease include rheumatic diseases, endocarditis, congenital heart valve diseases, and other heart diseases.

A person may have a higher risk of the disease if they are older, have a family history of valvular heart diseases, use certain medical devices, or have other heart diseases. Lifestyle choices can also increase a person’s risk, such as a lack of physical activity, an unhealthy diet, smoking, and obesity.

People can treat valvular heart disease with medications. In the most serious cases, a person may require surgery.