How to manage leaky heart valve

Leaky heart valve is a condition where a valve in the heart fails to close tightly enough, causing blood to leak back into the heart. The most common type of heart valve disease is mitral valve regurgitation, where the mitral valve is the source of the leak.

"The heart has four valves," says Roberto Rodriguez, MD, a cardiac surgeon and director of heart valve clinics at Lankenau Heart Institute, part of Main Line Health. "Each valve works as a one-way valve that opens to let blood flow in one direction then closes to prevent flow backwards. This allows blood to move from the right heart to the lungs, then to the left side of the heart and finally to the body. When a valve doesn't close properly, the blood leaks backwards and puts strain on the heart. This can lead to shortness of breath and other congestive heart failure symptoms."

What causes leaky heart valves

There are a few potential culprits, including age-related wear and tear on the valve, genetic conditions and certain infections or autoimmune disorders. Some people may also develop mitral valve regurgitation as a result of heart damage from a heart attack or another heart disease, including high blood pressure or a structural defect in the heart.

Symptoms of a leaky heart valve can include:

• Fatigue
• Shortness of breath
• Chest pain
• Swelling in the legs
• Abnormal heart rhythm

If you're experiencing symptoms like fatigue, shortness of breath or chest pain, it's important to see your doctor right away.

"While leaky heart valves can be serious, early diagnosis and treatment can help manage symptoms and prevent complications," says Dr. Rodriguez.

Diagnosing and treating leaky heart valve

A leaky heart valve is usually diagnosed by your doctor through obtaining a detailed medical history and through a clinical evaluation. During this evaluation, your doctor listens to your heart. Some of the signs of a leaky heart valve are the presence of a heart murmur, irregular heartbeat (such as atrial fibrillation), shortness of breath during walks or going up a flight of stairs and swelling of the ankles.

"If your doctor detects a heart murmur, they should order an echocardiogram to evaluate your heart muscle and heart valves," says Dr. Rodriguez.

Once diagnosed with a leaky heart valve, treatment will depend on the severity of symptoms and the underlying cause. Mild cases may not require any treatment beyond regular monitoring to make sure the condition doesn't progress. For more severe cases, medications or surgery may be necessary to repair or replace the affected valve.

"The good news is there are plenty of minimally invasive treatment options for a leaky heart valve," says Dr. Rodriguez. "Lankenau Heart Institute offers less invasive, newer-generation devices like transcatheter-based therapies to repair or replace the mitral, aortic or tricuspid valves."

Depending on the valve that is leaking, there are several minimally invasive procedures that can help, including:

Transcatheter options:

• Transcatheter aortic valve replacement (TAVR)
• Transcatheter mitral valve repair
• Transcatheter mitral valve replacement (TMVR)
• Transcatheter tricuspid valve replacement
• Transcatheter tricuspid valve repair
• Balloon valvuloplasty
• Paravalvular leak closure
• Cardiac defect closure

Minimally invasive surgical options:

• Aortic valve repair or replacement
• Mitral valve repair or replacement
• Tricuspid valve repair or replacement
• Mechanical valve replacements
• Bioprosthetic valve replacements

In addition to medical treatment, there are also lifestyle changes you can make to help manage your condition, including:

• Eating a heart-healthy diet
• Exercising regularly
• Avoiding tobacco and excessive alcohol consumption

Overcoming a leaky heart valve

Leaky heart valves are a serious condition that require prompt medical attention. But by working with your healthcare team and making lifestyle changes to support heart health, you can manage symptoms and enjoy a good quality of life even with this condition.

Next steps:

Make an appointment with Roberto Rodriguez, MD
Learn more about your options for heart valve disease treatment
Learn more about clinical trials for heart valve disease
Different types of heart murmurs — and what yours is telling you