Heart valve problems can affect people of all ages and can be caused by birth defects, age-related changes, infections, or other conditions. When one or more of the heart’s four valves do not open fully or allow blood to flow back into the heart chambers they connect, the heart’s ability to pump blood is impaired.

The heart’s structure

The heart consists of four chambers: two atria (upper chambers) and two ventricles (lower chambers). Blood passes through a valve as it leaves each chamber of the heart. These one-way valves prevent the backward flow of blood. The four heart valves include the following:

  • Tricuspid valve Located between the right atrium and the right ventricle

  • Pulmonary valve Located between the right ventricle and the pulmonary artery

  • Mitral valve Located between the left atrium and the left ventricle

  • Aortic valve Located between the left ventricle and the aorta

As the heart muscle contracts and relaxes, the valves open and close, letting blood flow into the ventricles and out to the body at alternate times. The left and right atrium contract once they are filled with blood. This pushes open the mitral and tricuspid valves. Blood is then pumped into the ventricles.

As the heart’s ventricles contact, the mitral and tricuspid valves close to prevent backward blood flow. At the same time, the aortic and pulmonic valves open to let blood be pumped out of the heart.

What is heart valve disease?

Heart valve disorders can arise from two main types of problems:

  • Regurgitation (oleakage of the valve) When the valve does not close completely, blood flows backward through the valve. This reduces forward blood flow and can lead to volume overload in the heart.

  • Stenosis (narrowing of the valve) When the valve opening becomes narrowed, it limits the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force to move blood through the narrowed or stiff valve.

Heart valves can develop both regurgitation and stenosis at the same time. Also, more than one heart valve can be affected at the same time. When heart valves fail to open and close properly, the effects on the heart can be serious, possibly hampering the heart's ability to pump enough blood through the body. Heart valve problems are one cause of heart failure.

What are the symptoms?

Mild to moderate heart valve disease may not cause any symptoms. These are the most common symptoms of heart valve disease:

  • Chest pain

  • Palpitations caused by irregular heartbeats

  • Fatigue

  • Dizziness

  • Low or high blood pressure, depending on which valve disease is present

  • Shortness of breath

  • Abdominal pain due to an enlarged liver (if there is tricuspid valve malfunction)

  • Leg swelling

On the surface, symptoms of heart valve disease may look like other medical problems, so be sure to discuss your symptoms with your doctor.

Treatment options

In some cases, your doctor may just want to closely watch the heart valve problem for a period. Treatment varies, depending on the type of heart valve disease, and may include:

  • Medication. Medications are not a cure for heart valve disease, but treatment can often relieve symptoms.

  • Surgery. Surgery may be needed to repair or replace the malfunctioning valve(s). Surgery may include:

    • Heart valve repair. In some cases, surgery on the malfunctioning valve can help ease symptoms. Examples of heart valve repair surgery include remodeling abnormal valve tissue so that the valve works properly, or inserting prosthetic rings to help narrow a dilated valve. In many cases, heart valve repair is preferable, because a person's own tissues are used.

    • Heart valve replacement. When heart valves are severely malformed or destroyed, they may need to be replaced with a new valve. Replacement valves may be either tissue (biologic) valves, which include animal valves and donated human aortic valves, or mechanical valves, which can consist of metal, plastic, or another artificial material. This usually requires heart surgery. But, certain valve diseases such as aortic valve stenosis or mitral valve regurgitation may be managed using non-surgical methods.

Patients who are not suited to open-heart surgery due to other medical conditions or elevated risk may be candidates for new, minimally-invasive mitral valve repair and replacement procedures offered by the experts at the WVU Heart and Vascular Institute.

To learn more about the Tendyne Bioprosthetic Mitral Valve implant and the FDA-approved MitraClip device, visit the Center for Mitral Valve Disease at the WVU Heart and Vascular Institute online here.

If you’re experiencing symptoms, call 855-WVU-CARE (855-988-2273) to make an appointment with a WVU Medicine physician.