What causes acquired heart valve disease?

Heart conditions and other disorders, age-related changes, rheumatic fever, and infections can cause acquired heart valve disease. These factors change the shape or flexibility of once-normal valves.

The cause of congenital heart valve defects isn't known. These defects occur before birth as the heart is forming. Congenital heart valve defects can occur alone or with other types of congenital heart defects.

Heart Conditions and Other Disorders

Heart valves and the support structure can be stretched and distorted by:

• Damage and scar tissue due to a heart attack or injury to the heart.
• Advanced high blood pressure and heart failure. These conditions can enlarge the heart or the main arteries.

Narrowing of the aorta due to the buildup of a fatty material called plaque inside the artery. The aorta is the main artery that carries oxygen-rich blood to the body. The buildup of plaque inside an artery is called atherosclerosis.

Age-Related Changes

Men older than 65 and women older than 75 are prone to developing calcium and other deposits on their heart valves. These deposits stiffen and thicken the valve flaps and limit blood flow (stenosis).

Rheumatic Fever

Some people have heart valve disease due to untreated strep throat or other infections with strep bacteria, which progress to rheumatic fever.

Infections

Common germs that enter through the bloodstream and get carried to the heart can sometimes infect the inner surface of the heart, including the heart valves. This rare, but sometimes life-threatening infection is called endocarditis. Endocarditis can worsen existing heart valve disease.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

Imagine that the heart's chambers are like rooms in a house, and that the heart's valves are like doors leading into those rooms. The doors can malfunction because rooms enlarge, causing the door hinges to spread apart, or because the doors themselves are damaged. Similarly, the heart can be damaged for a variety of reasons and its chambers can enlarge, preventing the valves from closing on their "hinges", or diseases such as rheumatic fever, infection or age-related changes can damage the valves. The most commonly acquired heart valve diseases are mitral regurgitation, which is leakiness of the mitral valve, and aortic stenosis, which is narrowing of the aortic valve. When severe, both conditions can require open heart surgery, although cardiologists can now perform minimally invasive procedures to fix these valves in appropriate patients.