Do You Know the Warning Signs of a Leaky Heart Valve?

The condition becomes more common as you get older, but often, the symptoms are subtle or easy to attribute to other age-related changes

Rachel Nania,

AARP

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En español

Published April 02, 2025

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It’s not just your back, legs and joints that become less limber as you age. Tissues in the heart can also endure some wear and tear over the years, causing them to become stiffer.

In some people, these changes can lead to a common cardiac condition known as a leaky heart valve, and if left unchecked, it can become serious, even leading to heart failure.

Here’s what you need to know about leaky heart valves, including the warning signs that could signal your ticker is in trouble.

What is a leaky heart valve?

The heart has four valves, “and the valves just have one job: to open and close so that blood keeps moving forward,” says Marc Gillinov, M.D., department chairman of thoracic and cardiovascular surgery at the Cleveland Clinic.

6 warning signs of a leaky heart valve

Fatigue
Heart palpitations
Shortness of breath
Swelling in the legs and feet
Coughing
Chest pain or pressure

Source: Cleveland Clinic

If one of the valves opens at the right time but doesn’t close when it’s supposed to, blood can leak backward instead of moving forward, meaning less oxygenated blood gets pushed out to the brain, liver, kidneys and all the organs that depend on a fresh supply.

“This means your heart has to work harder” to make up the difference, “which can cause major problems,” says Joanna Chikwe, M.D., a professor of cardiac surgery at Cedars-Sinai in Los Angeles.

Some of these problems can include an irregular heart rhythm known as atrial fibrillation (Afib), pulmonary hypertension and heart failure.

According to the Mayo Clinic, an estimated 10 percent of adults over the age of 75 have the most common type of leaky heart valve, known as mitral valve regurgitation, which occurs when the mitral valve does not close properly. The three other types of leaky heart valves include aortic valve regurgitation, tricuspid valve regurgitation and pulmonary valve regurgitation.

What causes a leaky heart valve?

In addition to age-related changes that take place in the heart — “It’s just like a car getting miles on it,” says Ahmet Kilic, M.D., associate professor of cardiac surgery and program director of the Johns Hopkins Cardiothoracic Surgery Residency Program at Johns Hopkins Medicine — other causes of a leaky heart valve can include:

Heart damage from a previous heart attack
Congenital heart disease, or a birth-related defect
Heart tumors
Rheumatic heart disease, or damage from rheumatic fever
Endocarditis, or inflammation of the lining of the heart valves, often from a bacterial infection.

High blood pressure can also contribute to a leaky heart valve, Kilic says.

What are the symptoms of a leaky heart valve?

Unlike some other heart conditions, symptoms of a leaky heart valve can be subtle, even absent. “Many people do not experience any symptoms, and their leaky heart valves may be discovered during a physical exam, usually by listening to their heartbeat with a stethoscope,” Chikwe says. If they hear a murmur, an ultrasound of the heart, called an echocardiogram, can help doctors pinpoint which valves are leaking, she adds.

People who do experience symptoms may notice breathlessness, “even when they are doing very light activity or even when they are lying down,” Chikwe says. Fatigue and heart palpitations are also common, and in some cases — “when things aren’t flowing like they should,” Kilic says — people might feel like they have a dry cough. “And it’s all the pressure kind of building up in their lungs, so to speak,” he adds. Swelling in the legs and feet can also indicate a leaky heart valve.

“It’s not like when you hit your toe, and you know which toe you hit. It’s these vague symptoms that come along that could be from aging or inactivity, or just any host of things,” Kilic says. However, it’s important not to sideline these symptoms, no matter how subtle.

“If you have symptoms like shortness of breath, fatigue, or exercise intolerance that is different from last year, see a doctor. Don’t attribute it to just getting older because it could be something that is correctable,” Gillinov says.

For the majority of patients, a leaky heart valve is not an immediate problem, Kilic says. “It’s just something that you’re aware of, and you do periodic surveillance echocardiograms with your cardiologist to make sure [it’s not getting worse].”

But for people with more concerning leaks that interfere with the heart’s function, medications that ease fluid buildup may be prescribed to help relieve some of the strain on the heart, Gillinov says. There are also surgical and nonsurgical procedures to repair or replace a damaged heart valve and help prevent serious complications.

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