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What Is Heart Valve Disease?
Your heart has four valves:
- Aortic
- Mitral
- Pulmonic
- Tricuspid
Birth defects, age-related changes, infections, or other conditions can damage one or more of your heart's valves. When your heart valves don’t open or close properly, it can make your heart work harder and affect its ability to pump blood.
How common is heart valve disease?
According to the American Heart Association, approximately 5 million Americans are diagnosed with heart valve disorders each year.
What is the most common heart valve disease?
The mitral and aortic valves are most often affected by heart valve disease.
What are the three types of heart valve disease?
Heart valve disorders usually arise from three main types of malfunctions:
- Atresia – Atresia is present at birth and occurs when the valve doesn’t form correctly in the womb.
- Regurgitation (or leakage of the valve) – A valve does not close completely, causing the blood to flow backward through the valve. The heart is forced to handle more blood, making it work harder.
- Stenosis (or narrowing of the valve) – A valve’s opening becomes narrowed, limiting the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force in order to move blood through the narrowed or stiff (stenotic) valve.
Heart valves can develop both regurgitation and stenosis at the same time and more than one heart valve can be affected simultaneously.
What causes heart valve disease?
Causes of and risk factors heart valve disease may include:
- A congenital birth condition.
- A history of rheumatic fever.
- Changes in the heart valve structure due to the aging process.
- Damage resulting from an infection.
- Damage resulting from a heart attack.
- Myxomatous degeneration, an inherited connective tissue disorder that weakens the heart valve tissue.
- Syphilis, if left untreated.
Complications of heart valve disease
When heart valves fail to open and close properly, your heart can be seriously affected and may not be able to pump blood adequately throughout your body. Heart valve problems increase your risk of heart failure and stroke.
Is valve disease serious?
If left untreated, valve disease can cause serious complications that could become life-threatening. It’s important to talk to your doctor if you’re having symptoms of valve disease and follow your doctor’s treatment recommendations.
How can I prevent heart valve disease?
You may not be able to control some of your risk factors for heart valve disease, such as aging and congenital conditions. However, eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol, avoiding recreational drugs, and controlling chronic conditions such as high blood pressure and high cholesterol may help to lower your risk.
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What Are the Signs and Symptoms of Heart Valve Disease?
The symptoms of heart valve disease vary depending on the type of heart valve disease you have, and which valve is affected. Common symptoms may include:
- Abdominal pain due to an enlarged liver (if there is tricuspid valve malfunction).
- Chest pain.
- Dizziness.
- Fatigue.
- Low or high blood pressure, depending on the type of valve disease.
- Migraine headaches.
- Palpitations caused by irregular heartbeats.
- Shortness of breath.
Symptoms of heart valve disease may resemble other medical conditions. Mild heart valve disease may not cause any symptoms at all.
In people whose heart valve disease comes on severely and suddenly, symptoms can occur quickly. If your disease develops slowly and your heart has time to adjust, you may barely notice your symptoms.
When should I see a doctor about my heart valve disease symptoms?
If you think you may have heart valve disease, you should consult your doctor. If your symptoms are sudden and severe, dial 911 or visit the nearest hospital emergency room.
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How Do You Diagnose Heart Valve Disease?
Your doctor may diagnose a heart valve problem during a physical exam by using a stethoscope to listen for a murmur (an abnormal heart sound).
What to expect during your visit
During your physical exam, your doctor will:
- Ask about your symptoms and when they started.
- Discuss your medical history.
- Listen to your heart with a stethoscope.
A doctor may order further tests if they hear a heart murmur or if you are having symptoms.
Tests to diagnose heart valve disease
Our experts use the latest diagnostic tests to learn about your heart valve condition, including:
- Cardiac catheterization – This diagnostic procedure involves the insertion of a tiny, hollow tube (catheter) through a large artery in your leg or arm leading to your heart in order to provide images of your heart and blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders.
- Chest x-ray – A chest x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
- CT angiogram – A CT angiogram is an imaging test that looks at the arteries that supply your heart muscle. Unlike a cardiac catheterization procedure, this test uses a powerful x-ray machine to produce images of your heart and heart vessels.
- Echocardiogram (Echo) – This noninvasive ultrasound test uses sound waves to evaluate your heart’s chambers and valves. The echo sound waves create an image on a monitor as an ultrasound transducer is passed over your heart.
- Electrocardiogram (ECG or EKG) – This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
- Magnetic resonance imaging (MRI) – MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
- Transesophageal echocardiogram (TEE) – TEE is a form of echocardiography that is performed by inserting a probe with a transducer into your esophagus rather than placing the transducer on your chest as in a traditional echocardiogram. A TEE provides a clearer image of your heart because the sound waves do not have to pass through skin, muscle, or bone.
- Two-dimensional echocardiogram (2D Echo) – This test uses ultrasound to display a cross-sectional “slice” of your beating heart, including the chambers, valves, and the major blood vessels that exit from the left and right part of your heart.
Your doctor or nurse will tell you when to expect your test results and will call you when they're available.
Heart valve disease prognosis
Early diagnosis and treatment of heart valve disease can improve your long-term outcomes and survival rate.
What is the life expectancy of a person with a bad heart valve?
Your life expectancy will depend on your age and overall health, how severe your symptoms are, how fast your condition progresses, and the type of treatment you have. Your doctor will discuss your life expectancy with you.
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How Do You Treat Heart Valve Disease?
Heart valve diseases are treated differently according to your individual health history and diagnosis. Based on the type and severity, we tailor treatments for your specific valve condition.
Medicine to treat heart valve disease
For mild to moderate heart valve disease, your doctor may recommend medicines and lifestyle changes to relieve symptoms and lower risk of developing a life-threatening condition.
Surgery for heart valve disease
For moderate to severe heart valve disease, your doctor may recommend heart valve repair or replacement surgery. Surgical treatment options may include:
- Aortic root surgery (David procedure) – Aortic root surgery is performed to treat an aortic root aneurysm, which is a weakening in the wall of your aortic root. When an aneurysm is located in your aortic root, it is impossible to treat the aneurysm without replacing your aortic valve.
- Aortic valve repair surgery – Although the aortic valve is usually replaced, aortic valve repair surgery may be an option. The goal of aortic valve repair surgery is to restore your aortic valve to its full function. Because aortic valve repair involves using your own tissue, there is a lower risk of valve failure and other complications. Also, you will not need to take blood thinning medications, which are required when mechanical aortic valve replacements are used.
- Aortic valve replacement surgery – If aortic valve repair surgery is not an option, your surgeon may replace your aortic valve with a plastic or metal mechanical valve, or a bioprosthetic valve, which is usually made from pig tissue.
- Double, or triple valve surgery, with or without heart bypass grafts – Our surgeons may suggest surgery that repairs or replaces multiple valves at the same time.
- iSVR: Intercostal surgical valve replacement – iSVR is a minimally invasive procedure that treats conditions of the aortic, mitral, and tricuspid valves. Using the iSVR approach, your surgeon can access your valves through the intercostal space between your ribs using a one-and-a-half-inch incision in your chest — without opening your chest.
- Heart valve surgery – Our surgeons perform traditional open-chest heart valve repair and heart valve replacement, as well as minimally invasive and catheter-based procedures.
- MitraClip®– MitraClip treats mitral regurgitation using a catheter-like tube that is threaded through your femoral vein in your leg and into your heart. After the tube is in place, your doctor will use the MitraClip device to clip the leaflets of your mitral valve together, which helps to prevent the backflow of blood into your heart.
- Mitral valve repair surgery – If you have mitral valve disease, the preferred treatment is a repair of your own valve, rather than a mitral valve replacement. Compared to mitral valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually eliminates the need for long-term use of blood thinners.
- Mitral valve replacement surgery – If your mitral valve is too damaged to be repaired, your surgeon may remove your damaged mitral valve and replace it with a plastic or metal mechanical valve, or a bioprosthetic valve, which is usually made from pig tissue.
- Minimally invasive tricuspid valve repair surgery – If you have tricuspid valve disease, the preferred treatment is a repair of your own valve, rather than a tricuspid valve replacement.
- Right chest approach mitral valve repair (mini-mitral) – Mitral valve repair surgery can be performed during a procedure called a right mini-thoracotomy, or “mini-mitral.” During a mini-mitral, your surgeon will make a three-inch incision between your ribs on the right side of your chest and use special surgical instruments to access and repair your mitral valve.
- Transcatheter aortic valve replacement (TAVR) – TAVR is a minimally invasive, catheter-based procedure that replaces the aortic valve in patients who have aortic stenosis.
- Tricuspid valve replacement surgery – If your tricuspid valve is too damaged to be repaired, your surgeon may remove your damaged tricuspid valve and replace it with a plastic or metal mechanical valve, or a bioprosthetic valve, which is usually made from pig tissue.
- Valvuloplasty – Balloon valvuloplasty is a minimally invasive procedure to repair a narrowed heart valve. During the procedure, a special catheter is threaded into a blood vessel in your groin and guided into your heart. The catheter, which contains a deflated balloon, is inserted into your narrowed heart valve. Once in place, the balloon is inflated to stretch the valve open, and then removed.
How effective is treatment?
With proper treatment and follow-up care, heart valve disease can be effectively managed. Surgical procedures for valve disease are safe and effective, providing symptom relief and enhanced quality of life.
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Why Choose UPMC for Heart Valve Disease Care?
At UPMC, we offer a full range of standard and minimally invasive procedures to treat all types of heart valve diseases. When you choose UPMC for your heart valve disease care, you will benefit from:
- Our heart valve disease treatment experience – Our surgeons have performed thousands of valve procedures in the last three years and have one of the largest cardiothoracic surgery programs in the U.S.
- Our cardiac surgeons – Our cardiac surgeons have pioneered novel cardiac surgical procedures, including new techniques for durable valve repair on both mitral and aortic valves.
- Our minimally invasive treatment options – UPMC is among a the most experienced, highest-volume TAVR centers in the U.S.
- Our commitment to research – Our structural heart team is at the forefront of emerging research on new techniques, devices, and approaches to treat valve disease.
By UPMC Editorial Staff.
Last reviewed on 2024-10-01 by Kathryn Fatigante, PA-C.
