Problems with Heart Valves

What is Heart Valve Disease?

Your heart is a muscle which pumps blood to your lungs and around the rest of your body.  The job of the heart valves is to make sure that blood flows only in one direction through the heart. There are four valves in your heart. The valves between the atria (the top chambers) and the ventricles (the bottom chambers) are the mitral (on the left) and the tricuspid (on the right).  These are there to make sure that the blood only goes into the ventricles. The valves where the blood leaves the ventricles, the aortic (on the left) and the pulmonary (on the right), only let blood out of the ventricle.

A diseased or damaged valve can affect the flow of blood in two ways.

• If the valve does not open fully, it will obstruct the flow of blood. This is called valve stenosis.
• If the valve does not close properly, it will allow blood to leak backwards. This is called valve incompetence or regurgitation.

Both stenosis and incompetence may put an extra strain on the heart and if you have stenosis, the valve can obstruct the flow of blood, so your heart may have to pump harder to force the blood past the obstruction. If you have incompetence, a leaking valve may mean that your heart has to do extra work to pump the required volume of blood forwards. 

In some cases heart valve disease may lead to the heart becoming enlarged and it may also cause the heart to become less efficient at pumping the blood around the body.  However, treatment of the condition can often help to prevent this from happening. 

What causes heart valve disease?

The main causes of valvular heart disease are:

• being born with an abnormal valve or valves (congenital heart disease)
• the effects of rheumatic fever
• ageing of the heart

What are the symptoms of heart valve disease?

The symptoms of valve disease vary from person to person.  People who have a mild condition may have few or no symptoms.  However, others may suffer from tiredness, breathlessness or swelling of the ankles. 

Even after a valve condition has been diagnosed, it can sometimes be 10 or even 20 years before you have any symptoms or require any treatment.

How is heart valve disease diagnosed?

Abnormalities of the heart valves are often picked up at a routine examination when the doctor listens to the heart with a stethoscope and hears an extra noise called a murmur. However, murmurs are also heard in completely normal hearts. The doctor will be able to tell from the type of murmur he or she hears whether you need to have further investigations. If you have symptoms or if you have a murmur that is suspicious, your doctor will probably arrange for you to have tests.  Please see the Test section on our website or download our booklet Tests for Heart Conditions

How is heart valve disease treated?

Some people with heart valve disease do not need any treatment but may have to have regular check ups.  However, other people may need medication or other treatment to help relieve their symptoms.  If you have a lot of symptoms or your valves are badly affected, you may be advised to have heart surgery.  This can greatly improve your symptoms and quality of life.   

What about every day life?

Some people may find that they have no symptoms and their daily activities are completely unaffected.  For other people they may feel restricted in the types of activities they feel able to do.  Your GP or heart specialist will be able to advise you on the types of activities that you can continue to do. 

What is Endocarditis?

Endocarditis is a rare but serious condition where the inner lining of the heart – most commonly one of the heart valves – becomes infected.

It affects about 1,500 people a year in the UK. Most of these people already have some form of abnormality in the structure of the heart. People who have a heart valve problem or those who have had surgery on their valve are at higher risk of endocarditis.

Up until recently, people at risk of endocarditis were advised to take antibiotics before having dental treatment and some other procedures. However all the latest relevant research has been reviewed and it has been concluded that it is very unlikely that there is any benefit from taking antibiotics before having dental treatment or certain other procedures. In other words, taking antibiotics before having dental treatment or other tests will not reduce your risk of developing endocarditis.

For more information and how to obtain an Endocarditis warning card please see our see our infomation sheet Endocarditis

For more information on the heart valve disease and the treatments, please see our booklet Valvular Heart Disease

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