The heart has
Each valve has leaflets (tissue flaps) that normally open and close as your heart beats to let blood flow through or out of your heart in the right direction.
Heart valve disease occurs when one of these valves doesn’t work (either open or close) properly.
Factors contributing to heart valve disease include age, genetics, and prior infection. Your risk for heart valve disease may increase if you have risk factors for coronary heart disease, such as high blood pressure, or you develop heart failure.
Heart valve disease can also be congenital, meaning it’s something you have from birth.
Heart valve disease can develop suddenly or gradually. Cases where it develops suddenly can involve the rupture of a leaflet supporting a valve or an infection in the heart valve. Symptoms may be immediately noticeable, or they may develop so slowly that they’re difficult to notice.
Your symptoms don’t necessarily determine the severity of your heart valve issues. You may still require treatment even if your symptoms aren’t noticeable.
Some forms of heart valve disease are mild and don’t require treatment. Others may require medication or surgery.
Since heart valve disease can interfere with the heart’s ability to pump blood through the body, it can lead to heart failure. Heart failure can also cause heart valve disease.
When symptoms or risk factors are present, it’s important to screen for heart valve disease, using an echocardiogram or other tests.
Here’s what you need to know about screenings and questions to ask your doctor.
Regurgitation
This occurs when one of your valves doesn’t close tightly, causing blood to leak backward in the wrong direction.
As a result, your heart may have to work harder to pump blood. This condition can develop over time, or you can be born with it. Types of heart valve disease that can involve regurgitation include:
- Mitral valve regurgitation. Blood leaks backward through the mitral valve back into the left atrium.
- Bicuspid aortic valve. The aortic valve has two aortic flaps instead of three, so it doesn’t close completely, causing the backward flow of blood. This is congenital, although symptoms might not develop until later in life.
- Mitral valve prolapse. Valve flaps bulge and don’t completely close as the heart muscles contract and relax.
- Tricuspid regurgitation. Blood leaks backward through the tricuspid valve into the right atrium, which may increase the size of the right atrium. This can occur from severe lung disease or pulmonary hypertension.
Stenosis
A valve opening can stiffen and become narrow, which limits the flow of blood. Types of heart valve disease that involve stenosis include:
- Mitral valve stenosis. The mitral valve doesn’t fully open due to narrowing, which restricts blood flow through the valve. This type of valve disease can occur after rheumatic fever, which can cause inflammation of the heart and blood vessels.
- Aortic valve stenosis. A narrowing of the aortic valve, which more commonly occurs with age but can also be congenital due to bicuspid aortic valve.
- Pulmonary stenosis. This occurs when the pulmonary valve doesn’t open correctly. It’s often congenital.
But having a heart murmur doesn’t necessarily mean you have heart valve disease. You’ll need testing to confirm a diagnosis or rule out other causes.
Since heart valve disease affects blood flow, you might notice these symptoms:
- unusual tiredness
- shortness of breath
- swelling in your abdomen or lower extremities
- heart palpitations
- dizziness
- low or high blood pressure
- chest pain
- exercise intolerance
See a doctor if you develop any of these symptoms.
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Doctors use other types of screenings, too. These include:
- Electrocardiogram. This noninvasive test records the electrical signals in your heart. It can detect heart abnormalities, heart diseases, and blocked blood vessels. It involves placing electrodes or sensors on your chest and then recording electrical signals as your heart beats.
- Transesophageal echo. This test also produces a picture of your heart. It involves placing a flexible tube down your throat into your esophagus to take images of your heart.
- Cardiac catheterization. This test involves inserting a thin flexible tube into a blood vessel and then feeding this tube to your heart. Doctors use this test to assess valve function, and they’ll typically place the tube in a blood vessel located in your arm, upper thigh, or neck.
- Chest X-ray. These tests use electromagnetic energy beams to create images of the heart, so your doctor can look for signs of heart enlargement and other heart problems.
- Stress test. A machine takes images of your heart as you complete a strenuous activity, such as walking or running on a treadmill. This test helps assess how well your heart functions and provides information about the severity of heart valve disease.
- Cardiac MRI. This test uses magnets to create an image of your heart. This provides information about the overall health of your heart.
Symptoms of heart valve disease can vary from person to person, as can the severity of the condition. Here are a few questions to ask about your diagnosis and treatment.
- When should I have an echocardiogram or other testing for heart valve disease?
- What can screening tell us about my heart?
- What are the next steps if testing reveals a problem?
- If my heart valve problem isn’t serious, will I need follow-up screenings in the future?
- What treatments are available for heart valve disease?
- What are the signs that my heart valve disease is getting worse?
Heart valve disease can affect your heart’s ability to pump blood properly. Even though some people don’t have symptoms, the condition can worsen and cause heart failure, stroke, or other serious issues.
It’s important to see a doctor for any cardiac symptoms (chest pains, heart palpitations, fatigue, dizziness, high blood pressure). They may recommend screening for heart valve disease.