Heart Valve Disease

What is heart valve disease?

Heart valve disease is a condition in which one or more of your heart’s four valves — the tricuspid, pulmonary, mitral and aortic — don't work correctly.

How do heart valves work?

Each of the four valves has a tissue flap that opens and closes with every heartbeat, ensuring that the blood flows in the right direction through the heart’s four chambers and into your body. Normally, with each heartbeat, blood returns from the body and lungs and fills the atria (the heart's two upper chambers). The mitral and tricuspid valves are located at the bottom of these chambers. As blood builds up in the atria, both valves open allowing the blood to flow into the ventricles (the heart's two lower chambers).

As the ventricles begin to contract, the mitral and tricuspid valves shut to ensure no blood flows back into the atria. Then, with the ventricles narrowed, blood is pumped through the pulmonary and aortic valves. The pulmonary valve opens to allow blood flow from the right ventricle into the pulmonary artery, which carries blood to the lungs to get oxygen.

At the same time, the aortic valve opens to let blood flow from the left ventricle into the aorta, which carries oxygen-rich blood to the body. As the ventricles relax, the pulmonary and aortic valves close to prevent blood from flowing back into the ventricles.

What are the leading problems caused by valves working improperly?

The three leading types of problems caused by valves working improperly are:

  • Regurgitation
  • Stenosis
  • Atresia

Regurgitation, or backflow, occurs when the valve does not close tightly. This causes blood to leak back into the chambers instead of flowing through the heart or into an artery. This is most often due to “prolapse,” which is when the flaps of the valve are floppy or bulge back into an upper heart chamber during a heartbeat. Prolapse is most common in the mitral valve.

With stenosis, the flaps of a valve thicken or stiffen. When this happens, the valve does not fully open, not allowing enough blood to flow through the valve. Some valves can have both stenosis and regurgitation.

Atresia occurs if a heart valve lacks an opening for blood to pass through.

What causes heart valve disease?

Congenital heart disease develops before birth while acquired heart disease develops over time. Sometimes, the causes of heart valve disease are unknown.

Congenital heart disease commonly involves pulmonary or aortic valves that hadn't formed properly before birth. Irregular formation of the valves may include deficiency of tissue flaps, wrong shape or size of the flaps or even the absence of an opening that allows blood to flow through.

Acquired heart valve disease, a condition that develops over time on normal valves, is more typical in the aortic or mitral valves. This heart disorder can be caused by age-related changes, rheumatic fever, and infections.

Both congenital and acquired heart valve disease can cause stenosis or backflow.

What are the symptoms of heart valve disease?

When any of the heart valves cease opening fully, or allow blood to leak back into the heart chambers, your heart may have to compensate by working overtime and possibly causing damage to itself. Symptoms of heart disease can include shortness of breath, weakness or dizziness, discomfort in your chest, heart palpitations, swelling in your ankles and more.

Although heart valve disease is a lifelong condition, for some people the symptoms might not appear until middle age or older. For others, as the disease degenerates, it can lead to heart failure, blood clots, or sudden cardiac arrest. 

How is heart valve disease treated?

In the course of time, you may need to have your defective heart valve(s) reconstructed or replaced. Even after reconstruction or replacement, you will probably need to take prescribed medicines and have regular checkups with your doctor.

Patient Resources

Transcatheter Aortic Valve Replacement (TAVR)

Make an Appointment

To make an appointment to discuss your need for treatment for heart valve disease or other cardiovascular treatment, call the U-M Frankel Cardiovascular Center toll-free at 888-287-1082 or email us at CVCCallCtr@med.umich.edu. Visit our Make an Appointment page for more information about what to expect when you call us.