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Symptoms, Causes and Diagnosis

Understanding Heart Valve Disease

You may have heart valve disease if one or more of your heart valves does not open or close properly due to things like infection, aging or birth defects. There are two types of heart valve disease: narrowing of the heart valve (resulting in what is often called a stenotic valve) and a leaky valve. Some patients may have both types of heart valve disease in one or more valves.

If you have been diagnosed with heart valve disease, you may have questions about your health and what to expect. To understand your condition, it can be helpful to learn more about how your heart works and the types of heart valve disease. Your doctor will run a series of tests to determine which type of heart valve disease you have, its possible causes and the best course of treatment.

How a healthy heart works

How heart valves work

Your heart has four valves that control the flow of blood to and from your heart: the tricuspid valve, pulmonic valve (also called pulmonary valve), mitral valve and aortic valve.

The heart’s four valves function like one-way doors to keep blood flowing in one direction. The valves are made up of two or three strong flaps of tissue called leaflets. The leaflets open to allow blood to flow through the valve and close to prevent blood from flowing back into the heart chamber.

Blood pressure changes within each heart chamber control the opening and closing of the heart’s four valves. When blood flow becomes compromised, you may experience mild to severe symptoms such as fatigue, weakness, shortness of breath or chest pain. 

Causes of heart valve disease

Heart valves may be impaired for a variety of reasons. Some people are born with heart valve defects (often called congenital defects) while others acquire valve damage from infection, the aging process or other diseases. Rheumatic fever and endocarditis are two causes of heart valve disease.

Rheumatic fever

Rheumatic fever typically results from untreated infection, such as strep throat. It causes the heart valve leaflets to become inflamed and may result in scarring, thickening or shortening of the valves. The valves then narrow, hindering the flow of blood to and from the heart. 

Rheumatic fever usually occurs in children ages five to 15, but the heart valve disease symptoms it causes may not show for years. 


Endocarditis is a serious bacterial infection that can be life threatening. It occurs when germs (especially bacteria) enter your blood stream during dental procedures, surgery, intravenous (IV) drug use or severe infections and attack your heart valves. This can leave holes in the heart valve or scar the valve tissue, causing the valve to weaken. 

Other causes

Other causes of heart valve disease include:

  • Coronary artery disease
  • Heart attack
  • Cardiomyopathy (heart muscle disease)
  • Throat infection
  • Syphilis (a sexually transmitted disease)
  • Hypertension (high blood pressure)
  • Aortic aneurysms
  • Connective tissue diseases

Less common causes of valve disease include tumors, some types of drugs and radiation. Sometimes the cause of heart valve disease is unknown.

Heart valve disease symptoms

Heart valve disease reduces the heart’s pumping ability. When one or more of the valves work improperly, the heart tries to compensate by working harder to deliver oxygen-rich blood to organs and tissues. The overworked heart may begin to fail, causing these symptoms:

  • Shortness of breath
  • Discomfort in your chest, particularly during activity
  • Rapid heartbeat or heart palpitations
  • Fatigue
  • Swelling of your ankles, feet or abdomen
  • Weakness or dizziness
  • Rapid weight gain

It is important to keep in mind that not everyone experiences these symptoms, even if their heart valve disease is severe or advanced.

Receiving a diagnosis

The earlier you receive a diagnosis, the more effectively you and your doctor can manage your heart valve disease so you can live a longer, more active life. Your doctor will order a variety of tests to make a diagnosis. He or she will want to determine the type of heart valve disease you have and how severe it is before recommending a treatment.