A leaking valve can certainly lead to fatigue. When a valve is leaking, some of the blood moves backward instead of moving forward. The heart has to work extra hard to handle the blood that isn't flowing efficiently. This usually leads to a reduction in blood that is ejected from the heart with each heartbeat. When blood is not flowing efficiently to the rest of the body, it can lead to fatigue. Heart valve disease does not usually present with chest pain, but some heart valve conditions can cause chest pain in some people.