Heart Valve Disease 101: Types, Causes, Symptoms, and Treatment

Heart valve disease is a type of heart disease that affects the normal functioning of your heart valves. Your heart valves are vital for your heart to work correctly and allow your heart to pump oxygenated blood and nutrients throughout your body.

Your heart valves operate like one-way doors that control blood flow to and from your heart to various parts of your body. Your heart has four valves that open each time your heart beats and close again to prevent blood from flowing backward.

Heart disease is relatively common in Australia, affecting around 500,000 – 600,000 people in 2021. Heart valve disease can be challenging to diagnose, so this number may be much higher. Treatment and management options are available. However, early detection is always preferable.

Here, we’ll explain precisely what heart valve disease is, provide an overview of the four valves that support your heart, and explain the signs and symptoms to watch out for. We’ll then guide you on seeking a diagnosis for heart valve disease and what treatment and support options are available. 

What is heart valve disease?

Heart valve disease occurs when one or more of your heart’s valves do not work correctly. Your heart has four valves that open and close with every heartbeat to keep the blood flowing in the right direction. When one or more heart valves are damaged, blood flow can become disrupted, leading to further cardiac complications. 

Your heart valves explained

The four heart valves all serve a specific function to keep blood flowing to and from your heart correctly. These four cardiac valves are called the tricuspid valve, the mitral valve, the pulmonary valve, and the aortic valve. 

• The tricuspid valve controls blood flow between the right atrium and right ventricle.
• The mitral valve controls blood flow between the left atrium and left ventricle.
• The pulmonary valve controls blood flow between the right ventricle and the pulmonary artery.
• The aortic valve controls blood flow between the left ventricle and the aorta.

This video from the Australian Heart Foundation provides an excellent visual overview of the different heart valves, how they function, and what happens when heart valve disease occurs.

3 types of heart valve disease

There are two main types of heart valve disease, valve stenosis or obstruction and valve regurgitation or insufficiency. A third type of heart valve disease is known as valve atresia. Some people may have more than one type of heart valve condition affecting their blood flow.

Type 1: Valve stenosis or obstruction
Valve stenosis or obstruction is when the valve(s) become narrow or blocked, restricting blood flow. This type of heart valve disease can become more common with age and can cause issues like high blood pressure in the lungs.

Type 2: Valve regurgitation or insufficiency
Valve regurgitation or insufficiency is when a valve does not close properly, causing leakage and blood flowing backward, preventing it from moving to the next chamber of the heart properly. Regurgitation can happen to any heart valve but is most common in the aortic valve and the mitral valve.

Type 3: Valve atresia
Valve atresia is when the heart valve has not formed properly, and body tissue obstructs the flow of blood from one heart chamber to the next.

5 common heart disease diagnoses

1. Aortic stenosis
Aortic stenosis occurs when the aortic valve hardens and narrows, restricting normal blood flow. This restriction forces the heart muscle to work harder to pump blood through the body, which over time can thicken the left heart chamber. If left untreated, this type of heart valve disease can cause serious complications like heart failure or other problems.

2. Mitral valve regurgitation (MR)
Mitral valve regurgitation (MR) or prolapse occurs when the mitral valve stretches and weakens, allowing blood to flow in the wrong direction. MR can be mild, with only a small amount of blood flowing backward, and may have no symptoms. In more serious cases of MR, blood flow is severely disrupted and may cause you to feel tired or out of breath.

3. Tricuspid valve disease (TS or TR)
Tricuspid valve disease (TS or TR) is when the tricuspid valve stops working properly, either because it is leaky or not closing properly (tricuspid regurgitation or TR) or because it becomes stiff and narrow (tricuspid stenosis or TS). 

4. Bicuspid aortic valve (BAV)
Bicuspid aortic valve (BAV) is the most common type of heart valve disease that is congenital, meaning it is present at birth, affecting between 1 and 2 % of the population. Your heart valves have tiny flaps called cusps, which open and close when your heart beats to ensure blood flows in the right direction. Most healthy heart valves have three cusps, but a bicuspid valve only has two, creating potential problems like aortic stenosis, aortic valve regurgitation, and an enlarged aorta.

5. Endocarditis
Endocarditis is an infection of the heart lining, usually caused by bacteria but sometimes results from a fungal or another type of infection. Endocarditis can be caused by infections that travel through the bloodstream from other parts of the body. If left untreated, endocarditis can cause serious damage to the heart valves.

What causes heart valve disease?

Knowing the exact cause of a person’s heart valve disease can be difficult. Doctors cannot always be sure what causes certain heart valve diseases even with sophisticated medical diagnostic tools. We know that the main common underlying factor is one or more of the valve’s cusps or leaflets failing to open or close properly.

The exact cause of heart valve disease can differ depending on whether it was present at birth (congenital) or was caused by another health condition or developed as a person ages. 

3 common causes of congenital heart valve disease (present from birth)

1. Bicuspid aortic valve
This occurs when the heart valve only has two flaps (cusps) to prevent improper blood flow, instead of the usual three. 

2. Ebstein’s abnormality
It is a rare congenital heart defect in which the tricuspid valve is in the wrong position and the valve’s cusps have not formed properly and does not function normally, allowing blood to leak back into previous heart chambers.

3. Pulmonary valve stenosis
This occurs when a baby is born with a narrowing of the valve between the lower right heart chamber and the lung arteries. 

4 common causes of heart valve disease resulting from heart damage

1. Heart failure or cardiomyopathy
Cardiomyopathy describes diseases of the heart muscle. Cardio = heart, myo = muscle, pathy = disease or pathology. Some other types of heart disease or causes of heart failure can cause damage to the heart valves, resulting in subsequent heart valve disease.

2. Heart attack
Heart attacks, also known as acute myocardial infarction, are a common cause of damage to the heart muscle, and can also cause damaged or diseased heart valves.  

3. Heart valve infection (endocarditis)
As described earlier, infection from bacteria, fungi, or other germs can travel through the bloodstream to affect the heart valves. Early detection and treatment of endocarditis are crucial to minimising damage to heart muscle and valves.

4. Rheumatic heart disease
This type of heart disease is caused by rheumatic fever, an inflammatory illness affecting connective tissue throughout the body, including the heart. Over time, rheumatic fever causes scarring and damage to the heart valves, preventing them from functioning normally.

3 Common causes of heart valve disease associated with ageing

1. Degenerative valve disease
Your heart valves slowly degrade as you age. This process happens quicker for some people than others based on a combination of genetic, environmental, and lifestyle factors. Over time, this degeneration can damage or weaken the heart valves.

2. Age-related calcification
Calcium can slowly build up in your body and harden the heart valves, leading to conditions like aortic stenosis.

3. Mediastinal radiation therapy
Some people who have had high exposure to radiation (such as some occupations and those who have survived cancer and had radiation therapy as children) have an increased risk of future damage and disease of the heart valves. 

Heart valve disease can have many causes and are often severe. However, they also often have great treatment options, which improve the earlier you detect the signs and symptoms and seek medical advice.

What are the symptoms of heart valve disease?

The signs and symptoms of heart valve disease are different for everyone and depend on the severity of the disease or damage to the heart valves. Some people have mild-moderate symptoms, while others suffer more extreme symptoms. Some people may even have a serious heart valve disease and have no symptoms. However, they still require treatment as soon as possible. Getting regular physical health exams is a great way to catch heart valve disease early, even if you aren’t experiencing any of the below symptoms:

• Heart murmurs (abnormal heart sounds heard under a stethoscope)
• Chest pain
• Fainting, dizziness, lightheadedness
• Irregular heartbeat
• Palpitations (fluttery, pounding, racing, or thumping feeling heartbeat in your chest)
• Tiredness
• Shortness of breath
• Swollen ankles and feet
• Abdominal swelling (more common with advanced tricuspid regurgitation).

Many symptoms of heart valve disease mimic those of other conditions, and having one or more of the above symptoms does not mean you have heart valve disease. However, if in doubt, always consult your medical professional to undergo a screening and diagnostic process.

How is heart valve disease diagnosed?

You will undergo a thorough screening process when you consult your doctor or general practitioner to investigate your symptoms. You will be asked questions about your symptoms and undergo a physical examination, including having your heart listened to with a stethoscope. Depending on the results of this screening, your doctor may advise further testing, including: 

1. Electrocardiogram (ECG)
This is to measure your heart’s electrical signals. 

2. Echocardiogram
This is to check the functioning of your heart valves and chambers.

3. Chest X-ray
This is to observe whether your heart is enlarged. 

4. CT scan of your chest
This is to observe the size and shape of your aorta.

When should you call triple zero (000)?

Some symptoms can be a sign of serious heart complications and may require an ambulance. Dial triple zero (000) if the below arises:

• Pain in your chest, arm, jaw, or back pain
• Very severe shortness of breath
• Going in and out of consciousness or collapsing.

How is heart valve disease treated?

The treatment plan for heart valve diseases is very individual; it will depend on several factors like the type and severity of the disease, its causes, its impact on your life, and the likelihood of successful recovery. Some of the treatment pathways you may explore with your doctor include the following:

• Medication
  Medicines won’t cure heart valve disease, but they do help control the symptoms. Beta-blockers, digoxin, and calcium channel blockers can reduce heart valve disease symptoms, control the heart rate, and prevent abnormal heart rhythms. Medications that control blood pressure, like diuretics and vasodilators, prevent additional strain on your heart muscle.
• Surgery
  Heart valve repair or replacement is an option to treat or cure heart valve disease. Heart valve repair may include remodelling heart valve tissue or inserting prosthetic rings to narrow a dilated valve. Heart valves may need to be replaced if they are damaged beyond repair, in which case a biological valve (from an animal or human donor) or prosthetic valves are inserted to restore normal cardiac function.
• Non-surgical balloon valvuloplasty
  Non-surgical balloon valvuloplasty is a less invasive option in which a small hollow tube is inserted into a blood vessel and guided to the heart. From there, a small balloon is inflated to open up a narrow heart valve, allowing normal blood flow to resume.

How Homage can support people with heart valve disease

If you or someone you love is living with heart valve disease, Homage is here to help. Our team of compassionate, professional, highly trained Care Pros is ready to support you and your family to lead as normal and fulfilling a life as possible while you recover from heart valve disease.

Being able to stay in the comfort and privacy of your own home when getting treatment for heart valve disease reduces unnecessary stress for the patient and their caregivers. All of our nurses are Australian-qualified nursing professionals who can support you with home care, personal care, administering medication, and recovering from surgery.

We can also support you in travelling to and from your medical appointments with our medical escort and patient transport service. No more waiting around for taxis or rideshares that may be late or unreliable, and no more relying on favours from friends and family or struggling with public transport. Heart valve disease can increase fatigue and shortness of breath, making reliable transportation essential. Whatever your needs are, we have a service to suit your lifestyle, preferences, and goals. Contact our friendly Care Advisors today for an obligation-free consultation, so you can get back to doing the things you love.