[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Heart](https://durgical.com/en/general-pathology/areas/heart/) › Valve disease: causes by valve # 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. Updated Nov 12, 2026 ## Key points - Commonest stenosis: calcific aortic stenosis; commonest cause of mitral stenosis: rheumatic heart disease. - Mitral regurgitation: myxomatous prolapse, ischemic papillary muscle dysfunction, dilated left ventricle, rheumatic disease, endocarditis. - Aortic regurgitation: dilation of the aortic root (hypertension, ageing, Marfan, syphilis, aortitis) or cusp disease (rheumatic, endocarditis, bicuspid). - Tricuspid regurgitation: usually functional, from right ventricular dilation; also endocarditis in drug users, carcinoid, Ebstein. - Pulmonary stenosis: congenital (Noonan, tetralogy) or carcinoid. ## 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](https://durgical.com/en/conditions/mitral-stenosis/) | Rheumatic heart disease (almost all); rarely annular calcification | Left atrial dilation, AF, pulmonary hypertension | | [Mitral regurgitation](https://durgical.com/en/conditions/mitral-regurgitation/) | Prolapse, ischemia or papillary rupture, LV dilation, rheumatic, endocarditis | LV and left atrial volume overload | | [Aortic stenosis](https://durgical.com/en/conditions/aortic-valve-stenosis/) | Calcific degeneration (tricuspid or bicuspid), rheumatic | Concentric LV hypertrophy | | [Aortic regurgitation](https://durgical.com/en/conditions/aortic-regurgitation/) | Aortic root dilation, bicuspid valve, rheumatic, endocarditis, aortitis | Eccentric LV hypertrophy, wide pulse pressure | | [Tricuspid regurgitation](https://durgical.com/en/conditions/tricuspid-regurgitation-and-tricuspid-valve-disease/) | RV dilation (functional), endocarditis, carcinoid, Ebstein | Right atrial dilation, systemic venous congestion | | [Pulmonary stenosis](https://durgical.com/en/conditions/pulmonary-valve-stenosis/) | Congenital, carcinoid | RV hypertrophy | ## Clinical notes - Acute regurgitation (papillary rupture, endocarditis) is poorly tolerated because the chamber has had no time to dilate. ## Memory aid Stenosis is the cusp's fault; regurgitation can be anyone's: cusp, ring, rope or muscle. ## 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. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/valve-disease-causes-by-valve/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Murmurs and the hemodynamics of valve disease](https://durgical.com/en/physiology/murmurs-and-the-hemodynamics-of-valve-disease/) - [Valve murmurs: the table to know](https://durgical.com/en/clinical-exam/valve-murmurs-the-table-to-know/) ## Connections ## Related 5 - [Calcific valve disease](https://durgical.com/en/general-pathology/calcific-valve-disease/) - [Rheumatic fever and rheumatic heart disease](https://durgical.com/en/general-pathology/rheumatic-fever-and-rheumatic-heart-disease/) - [Mitral valve prolapse: myxomatous degeneration and what it leads to](https://durgical.com/en/general-pathology/mitral-valve-prolapse-myxomatous-degeneration-and-what-it-leads-to/) - [Infective endocarditis](https://durgical.com/en/general-pathology/infective-endocarditis/) - [Non-infected vegetations: marantic, Libman–Sacks, carcinoid](https://durgical.com/en/general-pathology/non-infected-vegetations-marantic-libman-sacks-carcinoid/) ## Related conditions 6 - [Mitral stenosis](https://durgical.com/en/conditions/mitral-stenosis/) - [Mitral regurgitation](https://durgical.com/en/conditions/mitral-regurgitation/) - [Aortic Valve Stenosis](https://durgical.com/en/conditions/aortic-valve-stenosis/) - [Aortic regurgitation](https://durgical.com/en/conditions/aortic-regurgitation/) - [Tricuspid regurgitation and tricuspid valve disease](https://durgical.com/en/conditions/tricuspid-regurgitation-and-tricuspid-valve-disease/) - [Pulmonary valve stenosis](https://durgical.com/en/conditions/pulmonary-valve-stenosis/) [← All of general pathology](https://durgical.com/en/general-pathology/) 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](https://www.ncbi.nlm.nih.gov/books/NBK553135/) (StatPearls (NCBI Bookshelf), 2025); [Aortic Insufficiency](https://www.ncbi.nlm.nih.gov/books/NBK557428/) (StatPearls (NCBI Bookshelf), 2025); [Aortic stenosis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000178.htm) (MedlinePlus, US National Library of Medicine, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/valve-disease-causes-by-valve/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/valve-disease-causes-by-valve/