Heart Health Center

Leaky Heart Valve

A leaky heart valve might go unnoticed. Or it could cause health problems that could be either minor or serious. How serious a leaky heart valve is depends on how much it interferes with normal blood flow through the heart. Treatments include medicines, surgical repair, or replacement of the leaky valve. Observation over time is the most common approach to a leaky heart valve.

What Is a Leaky Heart Valve?

The heart has four valves. They include:

• tricuspid valve
• pulmonary valve (or pulmonic valve)
• mitral valve
• aortic valve

The valves actually consist of flaps that open to let blood flow in one direction as it moves through the chambers of the heart. Then the valves close to keep blood from flowing backwards into the chamber it just left. Normally, each valve, except the mitral valve, has three flaps. The mitral valve has two flaps.

Any of the four valves can become leaky. This means that just after the heart squeezes and pumps blood forward, some blood will leak back through the valve. A leaking valve is called valve regurgitation.

How Is a Leaky Heart Valve Diagnosed?

A doctor usually diagnoses a leaky heart valve by:

• Listening to the heart with a stethoscope for abnormal sounds, known as a heart murmur.
• Looking at the results of a heart ultrasound, known as an echocardiogram.

A person’s description of symptoms along with the exam and echocardiogram can determine how serious a leaky heart valve is.

Symptoms of a Leaky Heart Valve

Most often, a leaky heart valve causes no symptoms or problems. Many healthy people have one or more valves that are slightly leaky.

If the heart valve leak is severe, it impairs the forward flow of blood. This can cause symptoms of congestive heart failure, which include:

• Shortness of breath, especially with exertion or when lying flat.
• Leg swelling or fluid retention elsewhere in the body.

Other symptoms of a leaky heart valve may include:

• Lightheadedness
• Rapid heartbeat
• Heart fluttering or palpitations

Even when there is significant valve regurgitation, there may be no symptoms.

Leaky Heart Valve and Aortic Regurgitation

The type of regurgitation caused by a leaky heart valve depends on what valve is involved. The aortic valve causes aortic regurgitation.

Causes of a leaky aortic valve include:

• A bicuspid aortic valve, which means the valve has two flaps instead of the normal three.
• High blood pressure, or hypertension.
• Infection of the heart valve, known as endocarditis.
• Marfan syndrome.
• Rheumatic heart disease, which is uncommon in the U.S.

Most people with aortic regurgitation only require observation over time.

People with symptoms due to severe aortic valve regurgitation usually benefit from certain blood pressure medicines called vasodilators. Other drug treatments for congestive heart failure, such as diuretics, can be helpful in severe aortic regurgitation.

When aortic regurgitation is severe, surgery is usually the recommended treatment. A surgeon will usually replace the leaking aortic valve. But sometimes, the valve can be repaired.