Understanding Heart Valve Disease

Heart valve disease means one or more of your heart valves doesn’t work as it should.

It’s important to know:

  • Your heart has four valves that control blood flow.
  • You can be born with heart valve disease, or you can develop it later in life.
  • You can have damage or disease in more than one valve.
  • Heart valve disease isn’t as common as some other heart conditions, but the number of people who have it is increasing.
  • Heart valve conditions can range from harmless to severe.
  • Heart valve disease cannot be cured, but treatment can ease symptoms and improve your quality of life.

What is heart valve disease?

Heart valve disease happens when one or more of your heart valves doesn’t work well. This puts a strain on your heart. 

To understand valve disease, it helps to know the basics of how the heart and valves work when they function normally.

This video shows how the heart works. It includes the four valves and their roles in keeping blood flowing in the proper direction.

The heart muscle pumps blood through your body with each with each heartbeat:

  • The right side pumps oxygen-poor blood to the lungs, where it picks up oxygen.
  • The left side pumps oxygen-rich blood to the rest of the body to nourish organs and tissues.

The heart has four chambers:

  • A right atrium
  • A right ventricle
  • A left atrium
  • A left ventricle

Blood returns from the body to the heart on the right side, entering the right atrium. It flows through the right side of the heart, passing through two valves on its way to the lungs to pick up oxygen.

The oxygen-rich blood then returns to the left side of your heart, passing through two valves before it’s pumped out to the rest of your body.

Heart anatomy and blood flow

A diagram showing the anatomy of the human heart.

The heart’s four valves work like gates: opening to allow blood to flow through, then tightly closing to stop blood from leaking backward. This keeps blood flowing in the proper direction.

  • The tricuspid valve manages blood flow between the heart’s upper and lower right chambers. It has three cusps (flaps).
  • The pulmonary (pulmonic) valve opens to let blood flow from the heart’s lower right chamber into an artery to reach the lungs. It has three flaps or leaflets.
  • The mitral valve separates the upper and lower chambers on the heart’s left side.  It controls the flow of oxygen-rich blood from the lungs into the heart. It has two flaps or leaflets.
  • The aortic valve controls blood flow from the lower left chamber to the aorta — the artery that carries blood from the heart to the rest of the body. It has three cusps or flaps.

Heart valve anatomy

A graphic that shows the anatomy of valves of the human heart.

This illustration shows the heart’s four valves and their cusps or leaflets (flaps) that open and shut. Image credit: Wikipedia Commons

If the valves are damaged or diseased, they may not open or close properly. That forces your heart to work harder to pump blood. Blood may not leave your heart at the normal rate.

Who gets heart valve disease?

About 2.5% of the U.S. population has heart valve disease, according the Centers for Disease Control and Prevention. The number of people with this condition is rising as the population ages.

Heart valve disease causes and risk factors

  • Age: As you get older, calcium can build up on your valves. This makes the flaps stiff and unable to open fully. Men older than 65 and women older than 75 are most at risk.
  • Congenital heart defects: These are conditions you are born with that affect the heart’s structure or how it works.
  • Other heart problems: Some heart conditions can stretch or scar valve tissue, or affect function. These include heart attack, heart failure and arrhythmia.
  • Rheumatic fever: This infection (caused by untreated strep infections) can permanently damage heart valves.
  • Infective endocarditis: This is a bacterial infection of the heart’s lining or heart valves.
  • High blood pressure: This can cause your heart to work harder, stretching valves out of shape.

Signs and symptoms of heart valve disease

Symptoms can develop over many years or very quickly. Many people never realize they have a mild valve problem. Advanced valve disease, left untreated, can lead to heart failure, blood clots, stroke or death.

You might notice symptoms more when lying down. They can include:

  • Shortness of breath
  • Heart palpitations (when it feels like your heart is beating too hard, too fast, skipping a beat or fluttering)
  • Chest pain or discomfort
  • Swelling of the ankles, feet or belly
  • Rapid weight gain (3 pounds in one day is possible)
  • Tiring more quickly during exercise or daily activities
  • Dizziness or fainting

Types of heart valve disease

Heart valves can develop abnormally before birth, or they can wear out over time. You can also have more than one heart valve problem at the same time.

The main problems that affect heart valves are:

Stenosis (narrowing): Valve flaps are stiff or thickened and can’t open all the way. This makes it harder for blood to flow through.

Regurgitation (leaking): Valves don’t close properly, allowing blood to leak backward into a heart chamber.

Prolapse: The mitral valve’s two flaps bulge up into the heart’s upper left chamber.  Mitral valve prolapse is the most common valve disorder. It’s harmless in many cases. In others, it leads to leakage.

A diagram that shows a top view of the valves of the human heart.
This illustration from the Centers for Disease Control and Prevention shows two of the main types of heart valve disease: stenosis (narrowing) and prolapse (bulging and not fully closing).

Congenital heart valve defects

Heart valve structural issues that people are born with include:

  • Bicuspid aortic valve: Some people are born with an aortic valve that has only two cusps (flaps) instead of three. This can lead to problems with narrowing or leakage. Symptoms often don’t appear until middle age.
  • Pulmonary valve stenosis: With this condition, the leaflets (flaps) of the pulmonary valve are thick or stiff. This can lead to narrowing, making it difficult for blood to move from the heart to the lungs.
  • Ebstein’s anomaly: An anomaly is something different or unusual. Here, the tricuspid valve is in the wrong place, and its flaps don’t work properly. Symptoms can range from mild to severe.
  • Atresia: A heart valve may be missing or it may be shaped in  a way that prevents blood from passing through.
This video shows the most common type of heart valve stenosis (narrowing).

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