10 Common Symptoms of Heart Valve Disease You Should Know

Heart valve disease occurs when one or more of the four heart valves don’t function properly, affecting blood flow through the heart. The heart valves – mitral, tricuspid, aortic, and pulmonary – open and close with each heartbeat to ensure blood flows in the correct direction. When these valves become damaged, narrowed, or leaky, it can lead to various symptoms that significantly impact your quality of life.

Understanding the warning signs of heart valve problems is crucial for early detection and management. While some people may not experience noticeable symptoms initially, others develop clear indicators that require medical attention. This article explores the most common symptoms associated with heart valve disease to help you recognize when something might be wrong with your heart.

1. Shortness of Breath (Dyspnea)

Shortness of breath is one of the most prevalent symptoms of heart valve disease. This breathlessness typically occurs during physical activity or when lying flat, a condition known as orthopnea. As the heart valves fail to function properly, blood can back up into the lungs, causing fluid accumulation that makes breathing difficult.

You might notice this symptom:

• During routine activities like climbing stairs or walking short distances
• When lying down at night, requiring extra pillows to sleep comfortably
• As a sudden sensation of not getting enough air
• Accompanied by a feeling of chest tightness

The severity can range from mild discomfort during strenuous exercise to severe breathlessness even at rest, depending on how advanced the valve disease has become.

2. Chest Pain or Discomfort (Angina)

Chest pain associated with heart valve disease can feel like pressure, squeezing, or tightness in the chest. This symptom is particularly common in aortic valve stenosis, where the narrowed valve restricts blood flow from the heart to the rest of the body.

The chest discomfort may:

• Occur during physical exertion or emotional stress
• Radiate to the arms, neck, jaw, or back
• Last for several minutes
• Be accompanied by sweating or nausea
• Improve with rest

This type of chest pain occurs because the heart muscle isn’t receiving adequate oxygen-rich blood due to the compromised valve function.

3. Extreme Fatigue and Weakness

Persistent fatigue is a hallmark symptom of heart valve disease that can significantly affect daily functioning. When heart valves don’t work efficiently, your body’s tissues and organs receive less oxygen and nutrients than they need, leading to overwhelming tiredness.

This fatigue is different from ordinary tiredness because it:

• Doesn’t improve significantly with rest
• Makes routine tasks feel exhausting
• Worsens as the day progresses
• May be accompanied by general weakness in the limbs
• Can affect your ability to concentrate or think clearly

Many people with heart valve disease report feeling drained even after minimal physical activity, and this exhaustion can interfere with work, social activities, and overall quality of life.

4. Heart Palpitations

Palpitations are sensations that your heart is racing, pounding, fluttering, or skipping beats. These irregular heartbeats are common in heart valve disease because the abnormal blood flow through damaged valves can trigger changes in heart rhythm.

People experiencing palpitations often describe them as:

• A fluttering sensation in the chest
• Feeling like the heart is “flip-flopping”
• Rapid or irregular heartbeats that you can feel in your chest, throat, or neck
• Episodes that come and go suddenly
• Sensations that may be accompanied by dizziness or lightheadedness

While palpitations can be harmless, when associated with heart valve disease, they may indicate atrial fibrillation or other arrhythmias that require medical evaluation.

5. Swelling in the Ankles, Feet, or Abdomen (Edema)

Fluid retention causing swelling is a significant symptom of heart valve disease, particularly when the tricuspid or mitral valves are affected. When these valves leak or don’t close properly, blood backs up in the veins, causing fluid to leak into surrounding tissues.

This swelling typically:

• Appears first in the ankles and feet
• Worsens throughout the day, especially after prolonged standing or sitting
• May leave an indentation when you press on the swollen area
• Can extend to the legs and abdomen in more severe cases
• May cause sudden weight gain due to fluid accumulation

The abdomen may also become distended and uncomfortable, a condition called ascites, which indicates more advanced heart valve disease.

6. Dizziness or Fainting (Syncope)

Episodes of dizziness, lightheadedness, or fainting spells are concerning symptoms of heart valve disease. These occur when the brain doesn’t receive adequate blood flow due to the heart’s inability to pump blood effectively through diseased valves.

These symptoms may manifest as:

• Sudden feelings of lightheadedness when standing up quickly
• Brief loss of consciousness or near-fainting episodes
• Sensation that the room is spinning (vertigo)
• Feeling unsteady or off-balance
• Episodes triggered by physical exertion

Fainting is particularly associated with aortic stenosis and can be a warning sign of severe valve disease requiring urgent medical attention.

7. Rapid Weight Gain

Sudden and unexplained weight gain is an important symptom of worsening heart valve disease. This weight increase isn’t due to increased fat or muscle mass but rather fluid accumulation in the body’s tissues.

Concerning weight gain patterns include:

• Gaining two or more pounds in a day
• Gaining five or more pounds in a week
• Weight increase accompanied by swelling in the extremities
• Clothes or shoes becoming tighter, especially around the waist and ankles
• Rings becoming difficult to remove from fingers

This symptom indicates that the heart is struggling to pump blood effectively, causing the kidneys to retain salt and water, leading to fluid buildup throughout the body.

8. Heart Murmur

A heart murmur is an abnormal sound heard during a heartbeat, created by turbulent blood flow through diseased heart valves. While a murmur itself isn’t something you can feel, it’s often the first sign that alerts doctors to potential heart valve problems during routine examinations.

Heart murmurs associated with valve disease:

• Are detected by a doctor using a stethoscope
• Sound like a whooshing or swishing noise
• Vary in intensity depending on the severity of valve damage
• May be present even when you have no other symptoms
• Can indicate either valve stenosis (narrowing) or regurgitation (leaking)

If your doctor detects a new murmur or a change in an existing one, additional testing is typically recommended to evaluate your heart valves.

9. Decreased Exercise Tolerance

A gradual decline in your ability to perform physical activities you once managed easily is a subtle but significant symptom of heart valve disease. This reduced exercise capacity occurs because your heart cannot meet the increased demands for oxygen and nutrients during physical exertion.

You might notice:

• Needing to stop and rest more frequently during activities
• Being unable to complete your usual exercise routine
• Feeling breathless or exhausted more quickly than before
• Avoiding activities you previously enjoyed because they’ve become too difficult
• A progressive worsening of this limitation over weeks or months

This symptom often develops gradually, so many people attribute it to aging or being out of shape, delaying diagnosis.

10. Persistent Cough or Wheezing

A chronic cough or wheezing, especially when lying down, can be a symptom of heart valve disease. This occurs when blood backs up in the lungs due to valve problems, causing fluid accumulation that irritates the airways.

Characteristics of this cough include:

• Producing white or pink blood-tinged mucus
• Worsening at night or when lying flat
• Accompanied by wheezing sounds similar to asthma
• Persisting despite treatment for respiratory conditions
• Associated with shortness of breath

This symptom is often mistaken for respiratory conditions like asthma or bronchitis, but when related to heart valve disease, it indicates fluid congestion in the lungs that requires cardiac evaluation.

Main Causes of Heart Valve Disease

Heart valve disease can develop from various causes, ranging from congenital conditions to age-related degeneration. Understanding these causes helps in recognizing risk factors and taking preventive measures where possible.

Congenital Heart Defects

Some people are born with abnormal heart valves. These congenital defects may involve valves that are the wrong size, have malformed flaps, or don’t attach properly. The bicuspid aortic valve, where the aortic valve has two flaps instead of three, is the most common congenital valve abnormality.

Age-Related Degeneration

As we age, calcium deposits can accumulate on heart valves, causing them to stiffen and narrow. This calcification is a common cause of aortic stenosis in older adults. Additionally, the valve tissues can weaken and deteriorate over time, leading to valve regurgitation.

Rheumatic Fever

Rheumatic fever, a complication of untreated strep throat, can cause permanent damage to heart valves. Although less common in developed countries due to antibiotic availability, it remains a significant cause of heart valve disease globally, particularly affecting the mitral and aortic valves.

Endocarditis

Infective endocarditis is a serious infection of the heart’s inner lining and valves. Bacteria entering the bloodstream can attach to damaged heart valves, causing inflammation and destruction of valve tissue. This condition is more likely in people with pre-existing valve abnormalities or those with artificial valves.

Other Heart Conditions

Heart attacks can damage the muscles that support heart valves, leading to valve malfunction. Cardiomyopathy (heart muscle disease) can enlarge the heart, stretching and preventing valves from closing properly. Atrial fibrillation and other conditions affecting heart structure can also contribute to valve problems.

Autoimmune Diseases

Certain autoimmune conditions like lupus and rheumatoid arthritis can affect heart valves. These diseases cause inflammation throughout the body, including the heart tissues, potentially damaging valve structures over time.

Radiation Therapy

Previous radiation treatment to the chest area, often used for cancer treatment, can damage heart valves years later. The radiation causes scarring and thickening of valve tissues, leading to stenosis or regurgitation.

Prevention Strategies

While not all cases of heart valve disease can be prevented, especially those related to congenital defects or genetic factors, several strategies can reduce your risk or slow disease progression.

Prevent Rheumatic Fever

Prompt treatment of strep throat infections with appropriate antibiotics can prevent rheumatic fever and subsequent valve damage. Always complete the full course of antibiotics as prescribed, even if you feel better before finishing the medication.

Maintain Good Oral Hygiene

Regular dental care and good oral hygiene practices are important for preventing endocarditis. Bacteria from gum disease can enter the bloodstream and potentially infect heart valves. Brush and floss daily, and visit your dentist regularly for cleanings and checkups.

Manage Risk Factors for Heart Disease

Controlling conditions that affect overall heart health can help protect your valves:

• Maintain healthy blood pressure through diet, exercise, and medication if needed
• Keep cholesterol levels in check
• Manage diabetes effectively
• Achieve and maintain a healthy weight
• Avoid tobacco use and excessive alcohol consumption

Exercise Regularly

Regular physical activity strengthens the cardiovascular system and helps maintain overall heart health. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, unless your doctor advises otherwise based on your current heart condition.

Follow a Heart-Healthy Diet

Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats supports cardiovascular health. Limit sodium intake to reduce fluid retention and blood pressure, and minimize saturated and trans fats that can contribute to arterial damage.

Get Regular Medical Checkups

Routine physical examinations allow doctors to detect heart murmurs and other early signs of valve problems before symptoms develop. If you have risk factors for valve disease or a family history of heart conditions, inform your doctor so appropriate monitoring can be implemented.

Take Preventive Antibiotics When Necessary

If you have certain valve conditions or artificial heart valves, your doctor may recommend taking antibiotics before dental procedures or certain surgeries to prevent endocarditis. Always follow these recommendations carefully and inform all healthcare providers about your valve condition.

Frequently Asked Questions

Can heart valve disease go away on its own?

No, heart valve disease does not go away on its own. Once a valve is damaged, the condition typically remains stable or progressively worsens over time. However, with proper monitoring and management, many people live well with valve disease. Early detection and appropriate medical care are essential for managing the condition effectively.

How serious is heart valve disease?

The seriousness of heart valve disease varies greatly depending on which valve is affected, the severity of the damage, and how quickly it progresses. Mild cases may require only monitoring, while severe cases can lead to heart failure, stroke, blood clots, or sudden cardiac arrest if left untreated. Early diagnosis and proper management significantly improve outcomes.

At what age does heart valve disease typically occur?

Heart valve disease can occur at any age. Congenital valve problems are present from birth, while rheumatic fever typically affects children and young adults. Age-related degeneration usually appears in people over 60, with risk increasing with age. However, anyone with risk factors can develop valve disease regardless of age.

Is heart valve disease hereditary?

Some types of heart valve disease have a genetic component. Conditions like bicuspid aortic valve and certain connective tissue disorders that affect valves can run in families. If you have a family history of heart valve problems, inform your doctor so they can monitor you more closely for signs of valve disease.

Can exercise make heart valve disease worse?

The answer depends on the type and severity of your valve disease. Moderate exercise is generally beneficial and recommended for people with mild valve disease. However, those with severe stenosis or other serious valve conditions may need to limit certain activities. Always consult your doctor before starting or changing an exercise program if you have heart valve disease.

What is the difference between valve stenosis and regurgitation?

Stenosis occurs when a valve becomes narrowed or stiff, restricting blood flow through it. Regurgitation (also called insufficiency) happens when a valve doesn’t close properly, allowing blood to leak backward. Some people have both stenosis and regurgitation in the same valve, and these conditions require different management approaches.

When should I see a doctor about possible heart valve disease?

You should see a doctor promptly if you experience persistent shortness of breath, chest pain, fainting spells, rapid or irregular heartbeat, unusual fatigue, or swelling in your legs and ankles. If you have risk factors for valve disease or a family history of heart problems, discuss screening options with your healthcare provider during routine checkups.

Can stress cause heart valve disease?

Stress itself does not directly cause heart valve disease. However, chronic stress can contribute to high blood pressure and other cardiovascular conditions that may indirectly affect heart health. While stress doesn’t damage valves directly, managing stress is important for overall cardiovascular wellness.

References:

• Mayo Clinic – Heart Valve Disease
• American Heart Association – Heart Valve Problems and Disease
• National Heart, Lung, and Blood Institute – Heart Valve Diseases
• Johns Hopkins Medicine – Heart Valve Diseases
• Cedars-Sinai – Heart Valve Disease