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Heart Valves and Valve Disease

Heart Valves and Valve Disease

This leaflet gives an overview of heart valve disease. There are four separate leaflets that give details of the four common types of valve problem - mitral stenosis, mitral regurgitation, aortic stenosis and aortic regurgitation.

The heart has four chambers - two atria and two ventricles. The walls of these chambers are mainly made of special heart muscle.

Cross-section diagram of a normal heart
 

During each heartbeat both of the atria squeeze (contract) first to pump blood into the ventricles. Then both ventricles contract to pump blood out of the heart into the arteries. There are one-way valves between the atria and ventricles and also between the ventricles and the large arteries that take blood from the heart. These are:

  • The mitral valve - between the left atrium and the left ventricle.
  • The tricuspid valve - between the right atrium and the right ventricle.
  • The pulmonary valve - between the right ventricle and the pulmonary artery. (The pulmonary artery is the main artery that takes blood from the heart to the lungs to collect oxygen.)
  • The aortic valve - between the left ventricle and the aorta. (The aorta is the main artery that takes oxygen-rich blood from the heart to the body.)

The valves make sure that when the atria or ventricles contract, the blood flows the correct way through the heart and into the arteries.

See separate leaflet called The Heart and Blood Vessels, including details about the function of the heart and how the heart beats.

A valve that is diseased or damaged can affect the flow of blood through the heart. There are two main types of valve problem:

  • Valve stenosis. This means that the opening of the valve is narrowed and the valve does not open fully. So, there is some restriction in blood flow through the valve.
  • Valve regurgitation (sometimes called valve incompetence, or a leaky valve). This means that the valve does not close properly and there is backflow of blood through the leaky valve.

Any of the valves can be affected by these problems. However, the mitral and aortic valves are the ones that most commonly become diseased. See separate leaflets called Mitral Stenosis, Mitral Regurgitation, Aortic Stenosis and Aortic Regurgitation.

Basically, the more narrow or leaky a valve is, the greater the problem is likely to be. Some minor narrowing or leakiness may cause no problems or symptoms. However:

  • If the narrowing is severe - the heart has to pump harder to get blood past the narrowing.
  • If leakiness is severe - the heart has to pump harder to pump the blood that leaks back, in addition to the normal amount of blood flowing through the heart.

In both cases, this can put a strain on the heart. There may be an increase in pressure behind the affected valve. This back pressure can cause blood and fluid to build up in the lungs or lower part of the body (depending on which valve is affected).

The symptoms that may develop include:

Various complications may develop, depending on the valve affected and the severity of the problem.

Degenerative changes

This is one of the most common causes of leaky heart valves. The structures supporting the heart valves weaken and stretch over time and this prevents the valves from closing properly.

Rheumatic heart disease

Rheumatic heart disease is a general term which means any heart problem which develops after having an episode of rheumatic fever.

Rheumatic fever is a condition which sometimes follows an infection with a germ (bacterium) called the streptococcus. Your body makes antibodies to the bacterium to clear the infection. But, in some people, the antibodies also attack various parts of the body - in particular, the heart valves. Inflammation of one or more valves may develop which can cause permanent damage and lead to thickening and scarring years later.

Rheumatic fever used to be common in the UK in the era before antibiotics but it is now rare. It is still quite common in some developing countries.

Other causes

Other causes of valve disease include:

If the narrowing or leakiness is mild, and you have no symptoms, you usually do not need any regular treatment.

If you develop symptoms or complications, various medicines may be advised to ease the symptoms.

Surgery to stretch, repair or replace the valve may be needed in some cases. Surgical treatment has greatly improved the outlook for many cases of severe valve disease. Surgery has a very good success rate.

If you have a diseased valve then endocarditis is a possible complication. Endocarditis is an infection of the valve. (Damaged valves are more prone than normal valves to infection.) Unless promptly treated, endocarditis can cause serious illness. See separate leaflet called Infective Endocarditis for details.

Further reading & references

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.

Author:
Dr Colin Tidy
Peer Reviewer:
Dr Adrian Bonsall
Document ID:
4723 (v44)
Last Checked:
27/07/2017
Next Review:
26/07/2020