Overview
Heart valve disease occurs when one or more of the four heart valves do not work properly. A valve may be too narrow (stenosis, limiting blood flow) or may leak (regurgitation, allowing blood to flow backwards). Mild valve disease may cause no symptoms for many years; severe disease can cause heart failure.
How common is it?
Heart valve disease becomes more common with age. Some people have no symptoms and are diagnosed after a heart murmur or another investigation.
Causes and risk factors
Valve disease can be present from birth (congenital) or develop over a lifetime from degenerative changes, rheumatic fever, infection, or other heart disease.
Common risk factors
- Age-related degenerative calcification (most common cause of aortic stenosis)
- Rheumatic fever in childhood (mitral stenosis)
- Infective endocarditis
- Mitral valve prolapse
- Previous heart attack affecting supporting structures
- Connective tissue disorders (Marfan syndrome)
- Congenital bicuspid aortic valve
Symptoms
- Many are asymptomatic until advanced disease
- Breathlessness on exertion or at rest
- Fatigue
- Palpitations
- Dizziness or fainting (particularly with aortic stenosis)
- Swollen ankles and legs
- Chest pain with exertion
When to see a doctor
Call your local emergency number for persistent chest pain, severe difficulty breathing or collapse. Seek prompt medical review for new or worsening breathlessness, dizziness, palpitations or swelling, whether or not valve disease has already been diagnosed. A new heart murmur may need further assessment.
Diagnosis
Echocardiogram (heart ultrasound) is the primary diagnostic test, measuring valve area, gradient, and degree of regurgitation. Cardiac MRI and catheterisation provide additional information before surgery.
Treatments
Surgical valve repair or replacement
Open-heart surgery to repair or replace a valve remains the gold standard for many types of valve disease. Tissue or mechanical valve replacements are used depending on age and circumstances.
TAVI (Transcatheter Aortic Valve Implantation)
Minimally invasive replacement of the aortic valve via catheter through the groin. Now the preferred option for older patients with aortic stenosis who are high surgical risk.
Medical management
Medicines can help symptoms or related heart problems but do not repair a damaged valve. Mechanical valves require a vitamin K antagonist, usually warfarin, with monitoring. Anticoagulation for atrial fibrillation depends on valve type and individual stroke and bleeding risks.
Self-care and lifestyle
- Attend regular follow-up appointments as valve disease may progress silently
- Maintain good dental hygiene and report dental procedures to your cardiologist (infective endocarditis prophylaxis may be needed)
- Inform your doctor before any surgical procedure
- Remain active within your symptoms and follow cardiac rehabilitation advice
Prevention
Not all valve disease can be prevented. Look after your teeth and gums, manage cardiovascular risk factors and follow medical advice about infections. Take antibiotics only when prescribed. People with valve disease should discuss any extra precautions for dental procedures with their care team.
Sources for targeted updates
Updated: 24 October 2026. Targeted corrections to frequency, urgent-care guidance, prevention, treatment. This update covers the named sections; a full review of the remaining guide is pending.