The heart is a complex organ that works around the clock to keep oxygen-rich blood flowing throughout the body. One important way the heart regulates blood's movement is with its valves. Heart valves ensure that blood moves in one direction through the heart. As blood passes from chamber to chamber, valves open to let it flow and then close to keep it from moving back into the chamber it just left.
The heart has four of these important valves:
- Aortic valve
- Mitral valve
- Tricuspid valve
- Pulmonic valve
When valves work perfectly, blood moves in only one direction.
But some people's heart valves don't close tightly enough. This can allow blood to leak backward as the valves are closing, or it can allow blood to squeeze past closed valves. This condition is called valve regurgitation, valve insufficiency, or a "leaky heart valve."
What Causes a Leaky Valve?
The mitral and aortic valves are the most commonly affected by regurgitation, but it can happen to any of the heart's valves. For some people, valve regurgitation develops slowly over a few decades. For others, it happens quickly and unexpectedly. Learn more about aortic regurgitation, mitral regurgitation, and tricuspid regurgitation.
A leaky heart valve can be caused by a number of conditions. Defects present from birth are sometimes the cause. In other cases, a leaky valve can be traced to:
- Calcification on the valves: Calcium deposits form on the valve that cause narrowing
- Injury: Physical trauma can damage the heart's tissue
- Mitral valve prolapse: Leaflets on the mitral valve bulge into the left atrium
- Infective endocarditis: an infection in the lining of the heart
- Rheumatic fever: A complication of untreated strep throat
- Cardiomyopathy: An enlarged heart that can stretch the tissue around the valves
What Are the Symptoms of a Leaky Valve?
Many people have no symptoms because the leak isn't severe. If it becomes severe, the heart has to work harder to keep blood moving around the body. Over time, this extra strain can damage the heart muscle and cause numerous symptoms:
How Are Leaky Heart Valves Diagnosed?
A primary care physician or cardiologist may perform a physical exam and find fluid in the lungs, an enlarged heart, or a heart murmur. These are all indicators that a heart valve may be leaky.
Further tests may be needed to confirm the diagnosis:
- Echocardiogram: An ultrasound taken with a hand-held wand placed on the chest or passed down the esophagus
- Cardiac catheterization: X-rays of the heart produced by injecting a dye into a catheter in the leg or arm
- Electrocardiogram (EKG or ECG): A test of the heart's electrical activity using electrodes attached to the skin
How Are Leaky Heart Valves Treated?
Sometimes a leaky valve is minor and doesn't need to be treated right away. In this case, the heart valve may be monitored to watch for changes.
In many cases, however, a repair or replacement is required. Left untreated, leaky heart valves can cause serious complications, including heart failure, atrial fibrillation (irregular heartbeat) or pulmonary hypertension (high blood pressure in the lung's vessels).
The good news is that valve problems are often quite treatable. Depending on which valve is causing the problem and the severity of your symptoms, your cardiologist or surgeon might recommend a surgical procedure or a transcatheter, minimally invasive procedure to repair or replace the leaky valve. Penn Medicine surgeons perform aortic valve repair and replacement surgery, tricuspid valve repair and replacement surgery, mitral valve repair and replacement surgery, and pulmonary valve repair and replacement surgery.
When possible, heart valves are repaired rather than replaced. Repairs have several benefits over replacements:
- Preserved function and strength of the heart muscle
- Lower the risk of a post-surgery infection
- No need to take blood-thinning medication