Heart valve problems
The heart has four valves that ensure blood flows in the correct direction between the different parts of the heart and the circulatory system. A heart valve problem means that one or more valves do not function normally. A valve may either leak (valve regurgitation) or become narrowed (valve stenosis).
The most common heart valve problems are aortic valve stenosis and mitral valve regurgitation. Symptoms often develop slowly, and mild valve problems may remain completely asymptomatic for a long time. More severe cases can weaken the heart’s pumping ability and require repair or surgery.
What causes heart valve problems?
Valve problems can be congenital or acquired. Acquired valve problems usually develop with age or as a result of other heart diseases.
The most common causes include:
- Aging – calcification especially in the aortic valve
- Rheumatic fever (rare today in Finland)
- Heart attack – may damage valve structures
- Enlargement of the heart – stretches valve structures, especially the mitral valve
- Congenital abnormalities – e.g., bicuspid aortic valve
- Cardiomyopathies or infections (endocarditis, myocarditis)
Types of heart valve problems
Valve regurgitation (insufficiency):
The valve does not close properly → blood leaks backward in the wrong direction. This burdens the heart and may lead to heart failure.
Valve stenosis:
The valve does not open properly → blood flow becomes restricted. The heart must work harder to pump blood forward.
A single valve may be both leaking and narrowed.
Symptoms of heart valve problems
The severity of symptoms does not always correspond to the severity of the valve problem. A mild defect may be asymptomatic, while a more severe defect causes clear symptoms such as:
- Shortness of breath, especially during exertion
- Fatigue, reduced exercise capacity
- Palpitations or sensations of arrhythmia
- Dizziness or fainting
- Chest pain
- Swelling in the legs or ankles
Symptoms may develop slowly over years or suddenly, for example due to an infection.
Diagnosis of heart valve problems
Heart valve problems are diagnosed with an echocardiogram. The examination shows the structure and function of the valves and the extent of any regurgitation or stenosis.
In addition, the following may be used:
Electrocardiogram (ECG)
Exercise test
X‑ray imaging (to assess the condition of the heart and lungs)
Laboratory tests
Regular follow‑up is important even in asymptomatic valve problems.
Treatment of heart valve problems
Mild valve problems may not require anything other than monitoring. When the defect causes symptoms or heart function declines, treatment options include:
Medication
Medications do not correct the valve defect itself but may relieve symptoms (e.g., diuretics, antiarrhythmic drugs, blood pressure medications).
Valve procedures
Valve repair: reshaping the original valve
Valve replacement: the defective valve is removed and replaced with a biological or mechanical prosthetic valve
Catheter‑based procedures (e.g., TAVI): especially for elderly or high‑risk patients, allowing aortic valve replacement without open‑heart surgery
The choice of procedure depends on the location and severity of the valve problem and the patient’s overall condition.
Living with a heart valve problem
It is often possible to live a long and good life with a heart valve problem when the condition is detected early and treatment is appropriate. Important factors include:
- Regular follow‑up with a cardiologist
- Monitoring symptoms and seeking evaluation in time
- Careful adherence to medication
- Maintaining healthy lifestyle habits: exercise, reducing salt intake, weight management
- Antibiotic prophylaxis during dental procedures if a prosthetic heart valve is in place
When to see a doctor?
Seek evaluation if:
- You have new heart‑related symptoms such as exertional shortness of breath, arrhythmias, or dizziness
- Your cardiologist has mentioned a valve problem and your symptoms have increased
- You have had heart valve surgery and want a follow‑up assessment
Heart valve problems can be treated effectively – often even without surgery. At the Heart Center, we take care of the monitoring, diagnosis, and, when necessary, further treatment of valve problems individually and safely.