Valvular heart diseases can take the form of stenosis, insufficiency (regurgitation), or a combination of the two. These defects are typically acquired as the result of infections, underlying heart disease, or degenerative processes. However, certain congenital conditions can also cause valvular heart diseases. Acquired defects are found primarily in the left heart as a result of higher pressure and mechanical strain on the left ventricle. The type of valvular disease determines the type of cardiac stress and subsequent symptoms. Valvular stenosis leads to a greater pressure load and concentric hypertrophy, while insufficiencies are characterized by volume overload and eccentric hypertrophy of the preceding heart cavities. Diagnostic procedures typically include ECGs, chest x-ray, and echocardiograms. Management consists of interventional or surgical procedures to reconstruct or replace valves, as well as medical treatment of possible heart failure.
- Aortic stenosis
- Age of onset: 40–60 years
- Severity increases with age
- Mitral stenosis: symptom onset between 20 and 39 years 
- Overall prevalence of 0.6 to 2.4 %
- Second most common valve defect
- More common in women
- Tricuspid valve defects: occur in < 1% of the population
- Pulmonary valve defects: rare outside of congenital conditions
Epidemiological data refers to the US, unless otherwise specified.
|Etiology of valvular heart conditions |
|Valve stenosis||Valve regurgitation|
|Left heart||Mitral valve|
|Right heart||Tricuspid valve|
|Pulmonary valve|| |
All valvular defects can eventually lead to symptoms of heart failure as a result of excessive strain on the ventricles.
- Complete heart examination: see and for details.
|Auscultation in valvular defects|
|Mitral regurgitation|| |
|Tricuspid stenosis (extremely rare)|
|Tricuspid regurgitation|| |
- Prevention of thromboembolism (if necessary)
The choice of procedure is based on the patient's individual risk profile and an evaluation of the risks and benefits. Options include:
Valve reconstruction (annuloplasty)
- Procedure: a ring-shaped device is attached to the outside of the valve opening to reestablish the shape and function of the valve
- Reduced thromboembolic risk compared to a mechanical prosthetic valve but high risk of recurring stenosis
- Lower mortality rate than valve replacements; however, replacements are more durable
- Prosthetic heart valve replacement
|Overview of prosthetic heart valve replacement options|
|Mechanical prosthetic valve||Biological prosthetic valve|
| || |
|Complications || |
Transcatheter aortic valve replacement (TAVR)
- A minimally invasive, percutaneous procedure in which the aortic valve is replaced through an endovascular technique
- A collapsible replacement valve is inserted via a catheter and placed over the native valve
- Once the replacement valve is expanded, it pushes the old valve aside and assumes its function.
- Transcatheter mitral valve replacement (TMVR)
Percutaneous balloon valvuloplasty
- Used to treat cardiac valvular stenosis
- A balloon is advanced into the target valve (either percutaneously or transapically) and inflated, opening the stenotic valve