What is a Leaky Heart Valve? Symptoms, Causes, & Treatments

Heart valve diseases affect about 2.5% of the US population overall, but the prevalence is up to 13% in older adults. The heart’s valves are flaps in the ventricles (lower heart chambers). They act as one-way inlets and outlets and ensure blood flows in the correct direction. In people with leaky heart valves, the flaps don’t close tightly, causing some blood to leak backward and flow in the wrong direction with each heartbeat — this is called valve regurgitation or valve insufficiency. Please continue reading to find out what causes heart valve disease, the symptoms, and treatment options.

What are the types of leaky valves?

There are four valves in the heart. The valve that is affected determines the type of heart valve regurgitation:

Mitral valve regurgitation: This occurs when there is a leaky mitral valve, which is the heart valve that controls the flow of blood from the left atrium (upper left chamber) to the left ventricle (lower left chamber). Mitral regurgitation is the most common type of leaky heart valve in which there is some blood flowing back into the left atrium with each heartbeat. Mitral valve prolapse is a heart valve disease in which the flaps (also called the cusps or leaflets) of the mitral valve are stretched or enlarged and bulge into the left atrium with each heartbeat, preventing the forward flow of some blood.
Aortic valve regurgitation: The aortic valve controls blood flow from the left ventricle into the aorta (the main blood vessel that takes oxygen-rich blood from the heart to the rest of the body). A leaking aortic valve does not close properly and allows backflow of blood into the left ventricle.
Tricuspid regurgitation: The tricuspid valve controls the flow of blood from the right atrium (upper right chamber) to the right ventricle (lower right chamber). If the tricuspid valve is leaky, some blood leaks backward into the right atrium.
Pulmonary valve regurgitation: The pulmonary valve controls the flow of blood from the right ventricle to the pulmonary artery. When this valve leaks, there is a flow backward of some blood into the right ventricle.

What causes a leaky valve?

Possible causes of a leaky heart valve include congenital heart disease (heart defects present from birth), rheumatic heart disease (damage to the heart valves due to rheumatic fever from untreated strep throat or scarlet fever), cardiomyopathy (a disease of the heart muscle), endocarditis (inflammation of the inner lining of the heart’s chambers and valves), damage to the heart from a heart attack, tumors in the heart, thoracic aortic aneurysm (a bulge in the aorta), and age-related breakdown (myxomatous degeneration) of valve tissue.

How serious is a leaking heart valve?

A leaking heart valve may or may not be serious. It can vary in severity from mild to moderate to severe, depending on the valve anatomy, blood flow, symptoms, and the effects of the leaky heart valve on your overall functioning.

A mild leaky heart valve that does not cause any symptoms may not be serious. On the other hand, a severe leaky heart valve is a serious problem. It can force your heart to work harder to pump blood and keep blood flowing in the right direction to get enough blood to every part of the body.

Without treatment, a moderate or severe leaky heart valve can put you at risk of serious complications such as atrial fibrillation (irregular heartbeat), pulmonary hypertension (high blood pressure in the right side of the heart and arteries in the lungs), congestive heart failure, cardiomegaly (enlargement of the heart), and sudden cardiac arrest.

What are the symptoms of a leaking valve in the heart?

Mild valve regurgitation may not cause any symptoms. Moderate to severe heart valve regurgitation can cause chest pain, chest discomfort, chest pressure, rapid heartbeat or heart palpitations, weakness, fatigue, cough, shortness of breath with physical activity, and edema (leg swelling).

Does a leaky heart valve need to be repaired?

Whether you need repair or replacement of a leaky heart valve depends on the severity of your valvular heart disease. Cardiologists determine the severity of heart valve diseases based on medical history, symptoms, the presence of heart murmurs (abnormal sounds heard with a stethoscope), and the results of blood tests, chest X-ray, electrocardiogram (to check the heart’s electrical activity), cardiac catheterization (using a catheter to check the heart’s function), and heart MRI.

If you have mild symptoms of a leaky heart valve, you may not require treatment, at least immediately. Your cardiologist may recommend monitoring your blood pressure, cholesterol, and other risk factors for heart disease and incorporating lifestyle changes such as eating a healthy diet, reducing stress, and quitting smoking if needed.

If you have moderate to severe heart valve disease, you may need prescription medications, for example, to treat fluid retention. Your cardiologist may also recommend repair of the valve flaps or valve replacement surgery.

What is the treatment for leaky heart valves?

Treatment options for a leaky heart valve include:

Medications to treat fluid buildup and other symptoms or manage complications.
Heart surgery for valve repair or valve replacement. This is usually an open heart surgery, but it can be done with a minimally invasive or catheter-based approach in some cases. The valve can be a mechanical one or a tissue valve, for example, a porcine (pig) valve. People who have mechanical heart valves need to take a blood thinning medication (warfarin) for the rest of their lives.

Whether you will need surgery on an affected valve depends on various factors, including the severity of your valve disease, other co-existing heart conditions, your age, and overall health status.

What is the life expectancy of a person with a leaky heart valve?

People with leaky heart valves have life expectancies ranging between 5 and 15 years without surgical valve repair or replacement. The older a person is, the higher the chances that they won’t survive long after a diagnosis of a leaky heart valve. However, studies in people with mitral regurgitation have shown that valve repair or replacement restores the life expectancy of people with leaky heart valves to that of the general population, regardless of age.

References: