Heart valve problems

Valves in your heart ensure that blood flows in the right direction

Valves in your heart ensure that blood flows in the right direction

The movement of blood through the heart is regulated by a series of heart valves which ensure that the blood flows smoothly in a single direction.

What can go wrong with the heart valves?

If any of the four valves are diseased or damaged the flow of blood through the heart is affected and the heart cannot work efficiently enough. There are two main ways that valves can be affected:

  • Valves can leak: the valve does not close firmly enough to prevent the blood in the chamber leaking back through the valve. This is called valve regurgitation. The heart has to work harder as it tries to cope with the normal flow of blood as well as the extra blood that has leaked back through the valve.
  • Valves can narrow: the opening of the valve is narrowed and can not open fully, restricting blood flow between chambers. This is called valve stenosis. The heart has to work harder to overcome this restriction.

Heart valves can leak and narrow at the same time and it is possible for more than one heart valve to be affected.

Both leaking and narrowing valves can place additional strain on the heart muscle. The aortic and mitral valves, on the left side of the heart, are most commonly affected.

What are the symptoms?

Some people are not aware that they have a heart valve problem because the heart is coping and they don't have any symptoms. However, damaged heart valves increase the workload of the heart and can place additional strain on the heart muscle. In time, depending on which heart valve is affected and how badly, the following symptoms may appear:

  • Shortness of breath
  • Ankle swelling
  • Increased tiredness
  • Chest pain (angina or palpitations, i.e increased awareness of your heartbeat)
  • Dizziness and / or fainting

Your doctor may discover a valve problem when these symptoms are investigated.

What are the causes of heart valve problems?

Possible causes include:

  • Coronary heart disease: this can commonly contribute to a leaky mitral valve.
  • High blood pressure: this can commonly contribute to a leaky aortic valve.
  • Getting older: age causes the aortic valve to harden and narrow.
  • Wear and tear can cause valves to leak.
  • Infection can lead to damage causing aortic or mitral leaking. Rheumatic fever during childhood (or teenage years) used to be the main cause of heart valve damage. However, rheumatic fever is now rare in the UK.
  • Congenital heart problems: e.g. being born with an abnormal aortic valve can cause aortic regurgitation. Congenital valve problems often do not cause any problems until adulthood, when premature wear and tear may occur.
  • Cardiomyopathy (disease of the heart muscle).

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