What is heart valve disease?

Heart valve disease means that your heart valve or valves don't open or close properly.

Your heart’s valves are crucial for your heart to function normally.

If one or more of your heart valves is damaged or diseased, your heart may need to work harder to pump blood. This can disrupt blood flow to your body.

What are heart valves? 

Your heart has four valves that keep blood flowing in the correct direction between its four chambers (two atria and two ventricles).  

Each valve is like a one-way door. During each heartbeat, the valves open to let blood flow from their chambers and close to stop the blood flowing backwards.

The four heart valves are the: 

• Tricuspid valve – This controls the blood flow between the right atrium and right ventricle

• Mitral valve – This controls the blood flow between the left atrium and left ventricle

• Pulmonary valve – This controls the right ventricle and the pulmonary artery, the blood vessel that carries blood from the heart to the lungs

• Aortic valve – This controls the left ventricle and the aorta

Heart valve disease means that your heart valve or valves don't open or close properly. This can cause the blood flow through your heart to and from your body to be disrupted. 

What are the types of heart valve disease? 

There are a few types of heart valve disease. Some people may have a combination of more than one type of valve problem. 

Stenosis 

Stenosis is when your valve doesn't work properly because the valve flaps are thick or stiff. This can reduce blood flow, which causes strain on your heart. 

Regurgitation (or insufficiency)

This is when your valve flaps are ‘leaky’ and don't close properly. This lets blood leak back through your valve and can make your heart work harder to circulate blood around your body. 

Atresia 

Atresia is a condition in which the valve isn't formed correctly, and tissue blocks the blood flow between the heart chambers. 

What are the signs and symptoms of heart valve disease? 

Heart valve disease symptoms can be mild, moderate, or severe. In fact, some people with heart valve disease may not experience any symptoms at all. However, they may still have a valve problem that needs treatment.  

The signs and symptoms of heart valve disease include:  

• Abnormal sound when listening with stethoscope (heart murmur)
• Chest pain
• Fainting, dizziness or light-headedness
• Irregular heartbeat
• Palpitations (very fast fluttering, racing, thumping or a pounding feeling in your chest)
• Shortness of breath
• Swelling of ankles and feet
• Tiredness

If you experience any of these symptoms, please contact your doctor. If left untreated, heart valve disease can cause heart failure. 

One of the first signs of heart valve disease is often a heart murmur. A murmur is an abnormal sound that your doctor can hear when listening to your heartbeat with a stethoscope. The murmur is heard when blood flows through a heart valve that doesn’t open or close properly.  

It’s important to note that a murmur does not always mean that there’s a problem with your heart. Some people with a normal heart can have a murmur. 

What causes heart valve disease?  

It's not always possible to tell what causes heart valve disease. Some heart valve disease patients have abnormalities present from birth (congenital heart disease), others have disease that’s related to age, or is caused by another condition.  Heart valve disease caused by congenital heart disease may be due to: 

• Bicuspid aortic valve 

• Ebstein’s anomaly 

• Pulmonary valve stenosis

Heart valve disease caused by damage to your heart valves may be due to: 

• Heart failure or cardiomyopathy (a disease of the heart muscle) 

• Damage to the heart muscle from a heart attack 

• Heart valve infection (endocarditis) 

• Scarring from rheumatic fever (rheumatic heart disease) 

Heart valve disease caused by aging may be due to: 

• Degenerative valve disease – valves can slowly degenerate as you age. For example, mitral valve prolapse, a condition that affects nearly 2% of Australians, may result in mitral valve regurgitation that needs treatment. 

• Calcification due to ageing – calcium can accumulate on the heart's valves and lead to aortic stenosis. 

• Mediastinal radiation therapy (radiation to the chest) – survivors of childhood cancer who had radiation therapy have an increased rate of heart valve disease later in life. 

Although heart valve problems can potentially be severe and even life-threatening, these conditions can also be treatable. 

How is heart valve disease diagnosed? 

To diagnose heart valve disease, your doctor will review your symptoms and conduct a physical examination. Your doctor may use a stethoscope to listen for a heart murmur. 

Your doctor may also ask you to have some tests, such as: 

• Electrocardiogram (ECG) - This test measures your heart’s electrical signals. 

• Echocardiogram - This test shows how the heart valves and chambers are functioning. 

• Chest X-ray - These images show whether your heart is enlarged. 

• CT scan of your chest - This test shows the size and shape of your aorta, the main blood vessel leaving the heart. 

How is heart valve disease treated? 

Treatment for heart valve disease depends on the cause of your disease and the impact that it’s having on your heart. Most valve problems can be treated using medication or heart valve surgery in serious cases. A cardiologist (expert heart doctor) will provide your care.

Common treatments for heart valve disease include:

• Surgery, or a procedure to repair or replace a valve 

• Valvuloplasty (using a balloon to widen a narrowed heart valve) 

• Medication for managing symptoms. 

If a heart valve starts to affect your heart’s ability to pump blood around the body, it may need repair or replacement. Your doctor may perform the following procedures: 

• Heart valve repair – surgery or procedures can preserve your heart’s valve.  

• Heart valve replacement – this surgery or procedure is performed if the valve can’t be repaired. The damaged valve is removed and replaced with a mechanical valve or one made from cow, pig or human heart tissue (biological tissue valve). Transcatheter aortic valve implantation (TAVI) involves putting in a new valve without removing the old valve.