Valve disease: causes by valve
- Topic
A valve can open too little (stenosis) or close too poorly (regurgitation). For each valve, a short list of causes explains most cases.
What it is
Valve disease produces stenosis, regurgitation or both. Stenosis is almost always a disease of the cusps themselves and is chronic; regurgitation can come from the cusps, the annulus, the chordae, the papillary muscles or dilation of the ventricle or aortic root, and can be acute or chronic. A few diseases explain most cases: calcific degeneration, rheumatic heart disease, myxomatous degeneration, infective endocarditis, ischemia and dilation of the ring.
Main causes of valve disease, valve by valve
| Lesion | Main causes | Effect on the heart |
|---|---|---|
| Mitral stenosis | Rheumatic heart disease (almost all); rarely annular calcification | Left atrial dilation, AF, pulmonary hypertension |
| Mitral regurgitation | Prolapse, ischemia or papillary rupture, LV dilation, rheumatic, endocarditis | LV and left atrial volume overload |
| Aortic stenosis | Calcific degeneration (tricuspid or bicuspid), rheumatic | Concentric LV hypertrophy |
| Aortic regurgitation | Aortic root dilation, bicuspid valve, rheumatic, endocarditis, aortitis | Eccentric LV hypertrophy, wide pulse pressure |
| Tricuspid regurgitation | RV dilation (functional), endocarditis, carcinoid, Ebstein | Right atrial dilation, systemic venous congestion |
| Pulmonary stenosis | Congenital, carcinoid | RV hypertrophy |
Clinical notes
- Acute regurgitation (papillary rupture, endocarditis) is poorly tolerated because the chamber has had no time to dilate.
Test yourself
Think of the answer, then tap the question to see it.
What is the commonest cause of mitral stenosis?
Rheumatic heart disease.
Which causes of aortic regurgitation act through the aortic root rather than the cusps?
Dilation from hypertension or ageing, Marfan syndrome, syphilitic aortitis or other aortitis.
Why is most tricuspid regurgitation called functional?
Because it results from right ventricular and annular dilation (often from left heart disease or pulmonary hypertension) rather than disease of the leaflets.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Mitral Regurgitation (StatPearls (NCBI Bookshelf), 2025); Aortic Insufficiency (StatPearls (NCBI Bookshelf), 2025); Aortic stenosis: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2025).
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Representative model, for educational purposes only.