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So, before we talk about what the symptoms are for a leaky heart valve, let's talk a little bit about what the heart valves are, and what their function is in the heart. The heart valves are doors in the heart that are supposed to open widely and let blood flow in one direction of the heart, and then close tightly, without letting any back flow, or regurgitation, what we call leakiness in the heart.
Leaky heart valves are not uncommon. They can be caused by several things. Some are deteriorations over time, and people with heart valves that were abnormal from birth, and others are things that are picked up along the way, like infections that can attack the heart valve, or a buildup of atherosclerosis that can cause calcification, or thickening of those heart valves.
There are four main valves in the heart. For the most part, symptoms usually come when one of the two left-sided heart valves have a problem. Your doctor is usually able to pick this up when they listen to your heart with a stethoscope and hear what we call a murmur, or abnormal heart sound. Once your doctor identifies the murmur, he or she will send you for further imaging. Most often, we use cardiac ultrasound to take a good picture of the heart and see how the valves are functioning. We have waves on the cardiac ultrasound to tell us the heart valves are too leaky or too stiff and whether or not they're functioning well overall.
When valves don't function properly, they can do one of two things. They can either be pretty tight, or stenotic, or leaky, or regurgitant. Either one can lead to some symptoms. Those symptoms would be shortness of breath when you exert yourself, or lower extremity swelling, or edema. Usually, they come on pretty gradually and you would notice an increase of symptoms over time such as the lack of ability to walk up a flight or two of stairs, something you might have been able to do just a few months or a year before. The other thing would be increased swelling in the legs. And you might notice at the end of a long day that your legs are more swollen than they used to be. These are the two main signs of a leaky or tight heart valve.
For the most part, leaky heart valves show up as an inability to exert yourself, shortness of breath, or swelling of your feet or legs. The main heart valves which can be leaky would be the left-sided heart valves, which we call the aortic valve or the mitral valve. And that's what you really need to know about a leaky heart valve.