Heart valve disease refers to any of several conditions that prevent one or more of the valves in the heart from functioning adequately to assure proper circulation. Left untreated, heart valve disease can reduce the quality of life and become life-threatening. In many cases, heart valves can be surgically repaired or replaced, restoring normal function and allowing a return to normal activities.

As an international referral center, the Cleveland Clinic has a long history and an excellent reputation for treating heart valve disease. This information will help you learn about heart valve disease and your treatment options.

What is heart valve disease?

There are four valves within your heart. They are the mitral, tricuspid, aortic and pulmonic valves. The valves make sure blood flows in only one direction through the heart.

Heart Valve Closed


Heart Valve Open


The valves consist of small flaps of tissue, called leaflets, that open to allow blood to move forward through the heart during half of the heartbeat and that close to prevent blood from flowing backward during the other half. The leaflets in two of the valves (the mitral and tricuspid) also have tough, fibrous strands of tissue called “chordae tendineae” that connect the valves to the muscles (papillary muscles) inside the walls of the ventricles. The chordae tendineae and papillary muscles keep the leaflets stable against any backward flow of blood.

Heart valve disease occurs when your heart's valves do not work correctly. Common causes of valve disease include rheumatic fever, birth defects, degeneration over time and infection. This can be caused by valvular stenosis or valvular insufficiency.

Normal mitral valve

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The strands connecting the leaflets to the muscles of the ventricles (papillary muscles) are the “chordae tendineae.”

In valvular stenosis, the tissues forming the valve leaflets become stiffer, narrowing the valve opening and reducing the amount of blood that can flow through it. If the narrowing is mild, the overall functioning of the heart may not be reduced. However, the valve can become so narrow (stenotic) that heart function is reduced, and the rest of the body may not receive adequate blood flow.

Another condition, called valvular insufficiency (or regurgitation, incompetence, "leaky valve"), occurs when the leaflets do not close completely, letting blood to leak backward across the valve. This backward flow is referred to as “regurgitant flow.” The heart has to pump harder to make up for this backward flow, and blood flow to the rest of the body may be reduced.

A narrowed or “stenotic” valve requires the heart to pump harder, which can strain the heart and reduce blood flow to the body.

A regurgitant (incompetent, insufficient, or leaky) valve does not close completely, letting blood move backward through the valve. The heart must then pump harder in the attempt to maintain blood flow to the body.

Some patients may have both valvular stenosis and valvular insufficiency in one or more valves.



Stenotic Valve

Stenotic Valve

What are the symptoms of heart valve disease?

When the heart valves begin to fail, the heart beats harder to compensate for the reduced blood flow. Over time, valve disease may progress to a point that symptoms begin to appear:

  • Increasing shortness of breath
  • Palpitations (skipped beats or flip-flop feeling in the chest)
  • Edema (swelling of the ankles, feet or abdomen)
  • Weakness or dizziness
  • Quick weight gain
  • Chest discomfort
  • Learn more about valve disease symptoms.

Last reviewed by a Cleveland Clinic medical professional on 03/21/2019.

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