Leaking valves of the heart are referred to as having insufficiency or regurgitation. The most common valves to be affected are the aortic and mitral valves. Leaking valves are caused by several conditions, including myxomatous degeneration, infectious endocarditis and rupture of the chordae.
Myxomatous Degeneration
Myxomatous disease is a degenerative process in which the connective tissues that make up the valve are replaced by a gelatinous matrix, which cause the valves to become floppy. According to an article published in 2008 European Journal of Echocadiography, myxomatous disease usually affects the mitral valve. The floppiness of the valve causes prolapsing of the valve leaflets. This means that the valve leaflets do not close flush and blood is able to flow backward into the heart. Chordae, which are the thread-like structures that hold the valves in place can be stretched or ruptured in myxomatous disease. The symptoms of this disease are a "leaky" heart valve that creates a murmur.
Infectious Endocarditis
Bacteria in the bloodstream can travel to the heart and find their way to the valves. The bacteria attach to the leaflets of the valves and interfere with the normal opening and closing of the valves. Because the valve does not close all the way, it allows blood to flow back into the heart. According to the American Heart Association, there are about 29,000 cases of infectious endocarditis each year in the United States. Until recently, it was believed that having a gastrointestinal or dental procedure without preventive antibiotics was a risk for infectious endocarditis. The American Heart Association along with other experts now feel that there is no conclusive evidence that links infectious endocarditis to gastrointestinal or dental procedures in patients who are at low risk of developing the disease. Those with the greatest risk of developing endocarditis should still be treated with preventive antibiotics before a gastrointestinal or dental procedure. Those at high risk include patients with a prosthetic heart valve, those with congenital heart defects and patients who have had cardiac transplants.
Chordae Rupture
Chordae are thread-like structures that hold the valve in place and allow it to open and close. When the chordae rupture, the valve looks like a flag blowing in the breeze on echocardiography. Chordae rupture because of heart attack, myxomatous degeneration, infectious endocarditis and trauma. Rupture of the chordae can be a medical emergency, causing a significant drop in blood pressure and hemodynamic instability.
