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Heart Disease Health Center

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Heart Valve Disease

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What Causes Heart Valve Disease?

Heart valve disease can develop before birth (congenital) or can be acquired sometime during one's lifetime. Sometimes, the cause of valve disease is unknown.

Congenital valve disease. This form of valve disease most often affects the aortic or pulmonic valve. Valves may be the wrong size, have malformed leaflets, or have leaflets that are not attached correctly.

Bicuspid aortic valve disease is a congenital valve disease that affects the aortic valve. Instead of the normal three leaflets or cusps, the bicuspid aortic valve has only two. Without the third leaflet, the valve may be stiff (unable to open or close properly) or leaky (not able close tightly).

Acquired valve disease. This includes problems that develop with valves that were once normal. These may involve changes in the structure or your valve due to a variety of diseases or infections, including rheumatic fever or endocarditis.

  • Rheumatic fever is caused by an untreated bacterial infection (usually strep throat). Luckily, this infection was much more common before the introduction of antibiotics to treat it in the 1950s. The initial infection usually occurs in children and causes inflammation of the heart valves. However, symptoms associated with the inflammation may not be seen until 20-40 years later.
  • Endocarditis occurs when germs, especially bacteria, enter the bloodstream and attack the heart valves, causing growths and holes in the valves and scarring. This can lead to leaky valves. The germs that cause endocarditis can enter the blood during dental procedures, surgery, IV drug use, or with severe infections. People with valve disease can be at higher risk for developing endocarditis.

There are many changes that can occur to the valves of the heart. The chordae tendinae or papillary muscles can stretch or tear; the annulus of the valve can dilate (become wide); or the valve leaflets can become fibrotic (stiff) and calcified.

Mitral valve prolapse (MVP) is a very common condition, affecting 1% to 2% of the population. MVP causes the leaflets of the mitral valve to flop back into the left atrium during the heart's contraction. MVP also causes the tissues of the valve to become abnormal and stretchy, causing the valve to leak. However, the condition rarely causes symptoms and usually doesn't require treatment.

Other causes of valve disease include: coronary artery disease, heart attack, cardiomyopathy (heart muscle disease), syphilis (a sexually transmitted disease), high blood pressure, aortic aneurysms, and connective tissue diseases. Less common causes of valve disease include tumors, some types of drugs, and radiation.

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