What is a leaky heart valve? Doctor explains causes, diagnosis, and risks

Conditions of the heart often develops silently over time, refusing attention until they begin to impact everyday life. One of such conditions is a Leaky Heart Valve or heart valve regurgitation, which causes blood to flow backwards with each heartbeat. Many people go on with their lives for years without knowing that one of their heart valves is not functioning properly. The American Heart Association says that Valvular Heart Diseases (VHDs) still remain underdiagnosed and undertreated despite management advancements. What makes them risky is that their symptoms can be vague or mimic everyday fatigue. However, even a minor leak can place strain on the heart and increase the risk of complications. Knowing when to take action is key to protect long-term heart health.

What is a leaky heart valve?

Heart valve regurgitation happens when one of the four valves of the heart is not able to close tightly. This causes it to “leak,” and some blood flows in the wrong direction each time the valve closes. Valves are supposed to be one-way doors that prevent blood from flowing backwards. While some damage to them is manageable and does not interfere with heart health, moderate or severe leakiness can lead to cardiac arrest, heart enlargement, or even failure. The severity of the condition is determined by the amount of blood that is flowing incorrectly. Then, medications may be used to manage the symptoms. In advanced cases, a heart valve repair or replacement surgery, or minimally invasive procedures like transcatheter valve repair are recommended.

What are the symptoms?

A leaky heart valve can result in a variety of symptoms, many of which are subtle at first but can worsen over time as the heart works harder to compensate for the backflow of blood. Most patients with mild regurgitation are simply monitored. However, repair becomes necessary when symptoms worsen or diagnostic signs point to cardiac stress. Here are key indicators:

●Chest pain or pressure: Often felt as tightness or heaviness, especially during exertion, this can indicate that the heart is straining to maintain normal blood flow.

●Coughing: A persistent cough, particularly when lying down, may occur due to fluid accumulation in the lungs caused by impaired heart function.

●Fatigue or weakness: Reduced blood circulation means less oxygen reaches muscles and tissues, leading to constant tiredness and lack of energy.

●Heart palpitations: A fluttering, racing, or irregular heartbeat may signal that the heart is overworking to compensate for the leaking valve.

●Shortness of breath during physical activity: Difficulty breathing while exercising or climbing stairs is a common symptom as the heart struggles to meet the body's oxygen demands.

●Swelling in legs and feet (edema): Blood pooling in the lower limbs due to poor circulation can cause visible swelling, especially by the end of the day.

●Heart enlargement on scans: Over time, the heart may become enlarged as it works harder to pump blood, a change that can be detected through imaging and indicates progression.

A leaky heart valve doesn’t always announce itself loudly, but its impact can quietly build over time. Even subtle symptoms can signal that the heart is under stress and adapting in ways that may not be sustainable long term. Advances in diagnostic tools and treatment options now allow for more proactive care, often before serious damage sets in. Paying attention to unusual physical changes and prioritising follow-ups can help prevent complications and support long-term heart health.

Dr Jatin Yadav, HOD & Consultant - Cardiothoracic Vascular Surgery, Manipal Hospital, Gurugram