Valvular heart disease occurs when one or more of the heart's four valves does not work properly. These valves act like one-way doors, opening and closing to keep blood moving in the right direction. When a valve becomes narrowed, leaks or doesn't open and close as it should, the heart has to work harder to pump blood throughout the body.
As the condition progresses, you could develop symptoms such as fatigue, shortness of breath, chest pain, dizziness or swelling in the legs and feet. Without treatment, valvular heart disease can increase the risk of serious complications, including heart failure, irregular heart rhythms and stroke.
Most cases develop gradually over time, often without noticeable symptoms in the early stages. As the condition progresses, symptoms can appear and worsen, making it important to seek medical care. An evaluation can help determine the best treatment approach, which can relieve symptoms, improve heart function and help you maintain a healthy, active lifestyle.
Common Types of Valvular Heart Disease
Valvular heart disease is classified by which of the heart's four valves is affected and whether the valve has become narrowed (stenosis) or leaky (regurgitation).
The most common types include:
- Aortic valve disease – Includes aortic stenosis, in which the valve narrows, and aortic regurgitation, in which the valve leaks and allows blood to flow backward into the heart.
- Mitral valve disease – Includes mitral regurgitation, mitral stenosis and mitral valve prolapse, all of which affect blood flow between the heart's left upper and lower chambers.
- Tricuspid valve disease – Includes tricuspid regurgitation and tricuspid stenosis, which affect blood flow through the right side of the heart.
- Pulmonary valve disease – Includes pulmonary stenosis and pulmonary regurgitation, conditions that affect blood flow from the heart to the lungs.
What Are the Complications of Valvular Heart Disease?
As valvular heart disease progresses, the heart must work harder to pump blood effectively. Over time, this extra strain can lead to heart failure, a condition in which the heart cannot pump enough blood to meet the body's needs. The risk of heart failure and other complications is greatest in people with severe valve disease or those who delay treatment.
Other potential complications of untreated or advanced valvular heart disease include:
- Atrial fibrillation, an irregular heart rhythm that increases the risk of blood clots and stroke
- Cardiomyopathy or weakening of the heart muscle
- Pulmonary hypertension or high blood pressure in the lungs
- Stroke, particularly in people with atrial fibrillation
- Infective endocarditis, a serious infection of the heart valves
- Reduced blood flow that can affect kidney function and other organs
Conditions Associated With Valvular Heart Disease
Valvular heart disease often occurs alongside other cardiovascular conditions or develops as a result of underlying health problems that affect the heart. Common related conditions include:
- Structural heart disease, including congenital heart defects such as a bicuspid aortic valve
- Coronary artery disease
- High blood pressure (hypertension)
- Rheumatic heart disease
- Connective tissue disorders, such as Marfan syndrome
- Chronic kidney disease, which can contribute to calcium buildup on the heart valves
What Are the Symptoms of Valvular Heart Disease?
Valvular heart disease does not affect everyone the same way. Some people, especially older adults, experience subtle symptoms such as decreased stamina, weakness or confusion instead of more typical heart-related symptoms. Others might mistake fatigue or shortness of breath for normal aging or a lung condition. Certain symptoms can also be more prominent depending on the affected heart valve or other underlying health conditions.
Common Symptoms
The most common symptoms of valvular heart disease include:
- Shortness of breath
- Fatigue
- Chest pain or pressure
- Heart palpitations
- Dizziness or lightheadedness
- Fainting (syncope)
- Swelling in the legs, ankles, feet or abdomen
- Reduced exercise tolerance
- Heart murmur (an abnormal heart sound detected during a physical exam)
Mild, Moderate and Severe Symptoms
Early-stage valve disease often causes few or no symptoms. As the condition progresses, symptoms typically become more frequent and severe, making everyday activities more difficult.
- Mild disease – Often causes no symptoms or only occasional fatigue, a mild heart murmur or slight shortness of breath during strenuous activity.
- Moderate disease – Symptoms become more noticeable and can include increasing fatigue, shortness of breath during routine activities, palpitations, chest discomfort or swelling in the legs and feet.
- Severe disease – Symptoms can occur even at rest and include severe shortness of breath, chest pain, fainting, significant swelling and signs of heart failure.
Although many symptoms develop gradually, some require immediate medical attention. Seek emergency care if you experience:
- Severe or persistent chest pain, especially with shortness of breath
- Fainting or loss of consciousness
- Sudden or severe shortness of breath
- Signs of a stroke, such as facial drooping, weakness or difficulty speaking
- Rapidly worsening swelling or other signs of heart failure
What Are the Causes and Risk Factors of Valvular Heart Disease?
Valvular heart disease affects millions of people worldwide and becomes more common with age, particularly after 65. Valve damage can result from congenital abnormalities, age-related changes, infections or other underlying medical conditions. Certain health and lifestyle factors can also increase your risk.
Underlying Causes
Valvular heart disease can result from:
- Age-related valve degeneration – Years of wear and tear can cause the valves to stiffen, thicken or lose flexibility.
- Calcified heart valves – Calcium deposits, particularly on the aortic valve, can narrow the valve opening and restrict blood flow.
- Congenital valve disease – Some people are born with abnormal heart valves, such as a bicuspid aortic valve.
- Rheumatic heart disease – Rheumatic fever can scar and permanently damage the heart valves.
- Infective endocarditis – A bacterial or fungal infection can destroy valve tissue.
- Coronary artery disease or heart attack – Damage to the heart muscle or supporting structures can affect how the valves function.
- Conditions that can damage valves – High blood pressure, autoimmune diseases and inherited connective tissue disorders can also contribute to valve damage.
Risk Factors
Certain factors make valvular heart disease more likely to develop or progress, including:
- Older age
- A family history of congenital valve disease, bicuspid aortic valve or inherited connective tissue disorders
- A history of rheumatic fever or infective endocarditis
- High blood pressure
- Coronary artery disease
- Chronic kidney disease
- Diabetes
- High cholesterol
- Smoking and / or excessive alcohol use
- Physical inactivity
- An unhealthy diet
How Is Valvular Heart Disease Diagnosed?
Your healthcare provider uses a physical exam, imaging studies and other heart valve tests to identify the affected valve and determine the severity of the condition. Early diagnosis helps guide treatment and reduce the risk of complications.
Medical Evaluation
A valvular heart disease diagnosis begins with a review of your medical history, symptoms and any personal or family history of heart disease. Your provider will ask about symptoms such as shortness of breath, fatigue, chest pain, dizziness, heart palpitations and when they began.
During a physical exam, your provider will also look for signs of valve disease, including:
- A heart murmur
- An irregular heartbeat
- Swelling in the legs, ankles or feet
- Abnormal blood pressure or pulse patterns
- Signs of fluid buildup in the lungs
These findings help determine whether additional heart valve testing is needed.
Diagnostic Tests and Procedures
Several tests are used to confirm valvular heart disease, identify the affected valve and determine how severe the condition is. These include:
- Echocardiogram – This ultrasound uses sound waves to create images of the heart and evaluate valve structure, blood flow and valve function.
- Electrocardiogram (ECG or EKG) – Measures the heart's electrical activity to detect abnormal heart rhythms or signs of an enlarged heart.
- Chest X-ray – Helps identify an enlarged heart or fluid buildup in the lungs caused by advanced valve disease.
- Cardiac MRI or CT – Provide detailed views of the heart and valves and can be used to evaluate complex cases or plan treatment.
- Cardiac catheterization – Measures blood flow and pressure inside the heart and is often performed before valve repair or replacement procedures.
- Blood tests – Used to check for infections, evaluate heart failure markers and identify other medical conditions that could affect the heart or treatment options.
Conditions With Similar Symptoms
Because the symptoms of valvular heart disease are similar to those of many other heart and lung conditions, healthcare providers often perform additional testing to rule out other causes. Conditions with similar symptoms include:
- Coronary artery disease
- Heart failure
- Cardiomyopathy
- Atrial fibrillation and other heart rhythm disorders
- Chronic obstructive pulmonary disease (COPD)
- Asthma
- Pulmonary hypertension
- Anxiety or panic disorders
What Treatments Are Available for Valvular Heart Disease?
Valvular heart disease treatment depends on the affected valve, the severity of the condition, your symptoms and your overall heart health. Mild valve disease might only require routine monitoring, while more advanced cases commonly need medication, heart valve repair or heart valve replacement.
The goal of treatment is to improve blood flow, relieve symptoms, protect heart function and prevent long-term complications. Your care team will develop a personalized treatment plan based on the type and progression of your valve disease.
Medications
Although medications cannot repair a damaged heart valve, they can help manage symptoms, reduce strain on the heart and treat conditions associated with valve disease. Common medications include:
- Diuretics (water pills) to reduce fluid buildup and ease swelling or shortness of breath
- Blood pressure medications to lower blood pressure and reduce the workload on the heart
- Blood thinners (anticoagulants) to reduce the risk of blood clots and stroke, particularly in people with atrial fibrillation or mechanical heart valves
- Antiarrhythmic medications or beta blockers to help control abnormal heart rhythms and heart rate
- Antibiotics to treat infective endocarditis or, in select high-risk patients, help prevent infection before certain dental or medical procedures
Procedures
When valve disease becomes more advanced, causes symptoms or begins to affect how well the heart works, a procedure is often recommended to improve blood flow. The right treatment depends on which heart valve is affected, the extent of the damage and whether the valve can be repaired or needs to be replaced.
Common procedures include:
- Heart valve repair – When possible, surgeons repair the existing valve to restore normal blood flow while preserving the natural valve.
- Heart valve replacement – If a valve cannot be repaired, it can be replaced with a mechanical or biological tissue valve based on your individual needs.
- Minimally invasive valve procedures – Many valve conditions can be treated through smaller incisions or catheter-based techniques, including Transcatheter Aortic Valve Replacement (TAVR) for aortic stenosis and transcatheter mitral valve repair for select patients with mitral valve regurgitation.
- Open-heart valve surgery – Traditional valve repair or replacement may be recommended for more complex valve disease or when minimally invasive approaches are not appropriate.
- Heart transplant and advanced heart failure therapies – For patients with severe heart failure, treatment options include heart transplantation or advanced mechanical circulatory support, such as ventricular assist devices (VADs).
Long-Term Monitoring and Follow-Up
Even after treatment, ongoing monitoring is an important part of managing valvular heart disease. Regular follow-up appointments and periodic echocardiograms allow providers to evaluate valve function, monitor disease progression and determine whether treatment needs to be adjusted. Many people with mild valve disease can safely delay intervention for years with careful surveillance and routine imaging.
Lifestyle and Dietary Changes
Healthy lifestyle habits play an important role in protecting heart health and slowing the progression of valve disease. Recommendations include:
- Following a heart-healthy diet that emphasizes fruits, vegetables, whole grains, lean proteins and healthy fats while limiting sodium and saturated fat
- Staying physically active with exercises appropriate for your condition and avoiding strenuous activity if advised by your provider
- Maintaining a healthy weight
- Controlling high blood pressure, diabetes and high cholesterol
- Quitting smoking and avoiding tobacco products
- Limiting alcohol consumption
- Taking medications exactly as prescribed and attending all follow-up appointments
People with moderate or severe valve disease should discuss exercise limitations, travel plans, pregnancy and dental procedures with their healthcare team. Special precautions may be recommended depending on the type and severity of their condition.
Prognosis & Long-Term Outlook of Valvular Heart Disease
Many people with valvular heart disease live active, fulfilling lives with early diagnosis, appropriate treatment and regular follow-up care. Advances in medications, minimally invasive procedures and heart valve repair and replacement have significantly improved long-term outcomes.
Living With Valvular Heart Disease
Valvular heart disease is often a chronic condition that requires lifelong monitoring. Following your treatment plan and maintaining heart-healthy habits can help manage symptoms, slow disease progression and reduce the risk of complications. Family members and caregivers can also play an important role by helping with medications, appointments and recognizing signs of worsening symptoms.
Recovery and Long-Term Outlook
Recovery varies depending on the affected valve, the severity of the disease, your overall health and how early treatment begins. Many people experience significant symptom relief and improved heart function after treatment, allowing them to return to work, exercise and other daily activities.
In terms of outlook, those with mild valve disease may only need regular monitoring, while others require medication, minimally invasive procedures or heart valve surgery to manage their condition. When valve surgery is needed, it can restore healthy blood flow, improve quality of life and help prevent complications. Even after successful treatment, ongoing follow-up care is important to monitor heart function, manage risk factors and identify any changes that require additional treatment.
Mental, Emotional and Social Effects of Valvular Heart Disease on Daily Life
Living with valvular heart disease can affect more than just your physical health. Symptoms such as fatigue, shortness of breath and uncertainty about the future can impact your emotional well-being, relationships and ability to participate in work and everyday activities. Recognizing these challenges and getting help can improve both quality of life and overall health outcomes.
Mental and Emotional Well-Being
It is common for people with valvular heart disease to experience a range of emotions, especially after receiving a diagnosis or learning they may need a heart procedure. Some people worry about symptom progression, treatment decisions or how the condition will affect their independence.
Common emotional challenges that can result include:
- Anxiety about symptoms, medical appointments or future treatment
- Depression related to physical limitations or changes in daily life
- Stress caused by managing a chronic heart condition
- Frustration with reduced energy levels or decreased physical abilities
Some healthy coping strategies to consider include:
- Learning about your condition and treatment options to feel more informed and prepared
- Talking openly with your healthcare team about symptoms and concerns
- Seeking support from family, friends or heart disease support groups
- Working with a mental health professional if feelings of anxiety or depression become persistent or interfere with daily life
- Practicing stress-reduction techniques, such as mindfulness, meditation or gentle physical activity approved by your healthcare provider
Social and Occupational Challenges
Valvular heart disease often affects many aspects of daily life, including work, family responsibilities and social activities. Fatigue, shortness of breath and reduced stamina can make physically demanding jobs or household tasks more difficult, while frequent medical appointments or recovery from a heart procedure often require temporary adjustments to work schedules and daily routines.
Some people limit exercise, travel or social activities because of symptoms or concerns about overexertion. Over time, these changes sometimes lead to feelings of isolation or a loss of independence.
With appropriate treatment and ongoing medical care, many people continue working, stay active and enjoy meaningful time with family and friends. If valve disease begins to interfere with your daily activities, work or emotional well-being, talk with your healthcare provider about treatment options, workplace accommodations and support services that help you maintain your quality of life.
The TGH Difference for Valvular Heart Disease
Valvular heart disease is a progressive condition that can range from mild to severe, but early diagnosis and appropriate treatment can help preserve heart function, relieve symptoms and improve long-term outcomes. Whether your condition requires routine monitoring, medication or advanced surgery, receiving treatment from an experienced structural heart program is essential.
At Tampa General Hospital, you'll receive comprehensive care through the Heart & Vascular Institute, home to one of the nation's leading heart disease programs. Additionally, we are recognized as one of the nation’s top hospitals for Cardiology, Heart & Vascular Surgery by U.S. News & World Report and one of Newsweek's America’s Best Hospitals for Cardiac Care. We provide advanced diagnosis, treatment and long-term management for all types of heart valve disease.
As part of an academic health system, the Heart & Vascular Institute works closely with our nationally recognized Heart Transplant Center to care for patients with advanced heart failure and other complex cardiovascular conditions. Through our partnership with the LifeLink Foundation, Inc., we perform a high volume of heart transplants and have some of the shortest average transplant wait times in Florida. The Heart & Vascular Institute also includes the Women's Heart Program and Cardio-OB Program, offering specialized cardiovascular care for women before, during and after pregnancy.
Whether you have mild valve disease or a complex structural heart condition, you'll receive personalized care from our multispecialty team. Structural heart cardiologists, cardiovascular surgeons, cardiac imaging experts, heart failure specialists and other experienced cardiac professionals work together to develop individualized treatment plans. We provide a full range of advanced procedures and therapies, including:
- Transcatheter Aortic Valve Replacement (TAVR)
- Minimally invasive heart valve procedures
- Heart valve repair
- Heart valve replacement
- Advanced mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with advanced heart failure who are not transplant candidates or choose an alternative to heart transplantation
If you have been newly diagnosed with valvular heart disease, are seeking a second opinion or need advanced treatment, TGH offers the expertise and technology to help you achieve the best possible outcome. Schedule an evaluation with our structural heart team by calling (813) 844-3900. To learn more about our transplant selection criteria, please call (800) 505-7769 (press 1 for the heart transplant program and ask for the referral coordinator) or contact the coordinator directly at (813) 844-4088.