Leaky Heart Valve vs. Hole in Heart: What's the Difference?

The heart has four valves. Each has flaps that open to let blood flow through as it travels through the heart. The flaps then close to prevent the blood from flowing back to the heart. A valve leaks when a flap does not close properly, allowing blood to leak backward and putting strain on the heart. This is also known as valve regurgitation.

Any of the valves may become leaky. Mitral valve regurgitation is the most common type of heart valve disease. Another is aortic valve regurgitation.

Heart valves may become leaky due to:

• High blood pressure
• Infection of the valve (endocarditis)
• Structural defect in valve
• Weakening of heart for other reasons

Depending on how much blood leaks through, a leaky heart valve may or may not cause symptoms. Slight or even moderate cases may have no symptoms. People may not even be aware they have a leak.

Severe leaks, however, may significantly affect blood flow and cause symptoms, such as shortness of breath, swelling in the legs or other parts of the body.

Other leaky heart valve symptoms may include lightheadedness, fatigue and a rapid heartbeat as the heart works harder to pump enough blood. This can raise the risk of heart failure, heart attack and stroke.

Many people with leaky heart valves may just require observation over time to monitor changes in their condition. If treatment is needed, medications can help manage blood pressure or treat symptoms. Surgery may be recommended to repair or replace the leaky valve.

“At Scripps, we treat many cases of mitral valve regurgitation with a minimally invasive procedure using the MitraClip, which is an FDA-approved device that allows us to repair heart valves without doing open heart surgery,” says Matthew Price, MD, an interventional cardiologist at Scripps Clinic John R. Anderson V Medical Pavilion in La Jolla.

The MitraClip device fixes valve leaks by clipping together the sections of the valve that are not closing correctly. The interventional cardiologist inserts a thin tube called a catheter is inserted into a leg vein and guided up to the heart and to the mitral valve.

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for treatment of aortic valve regurgitation. Scripps is a leader in both TAVR and MitraClip procedures.

Leaky heart valves also may be repaired or replaced with traditional open heart surgery. The patient’s cardiac care team will determine the most appropriate approach.

A hole in the heart is a condition where a hole exists in the wall (septum) between the chambers of the heart.

They are usually congenital birth defects, which means they are present at birth. During pregnancy, a baby’s septum normally has several openings that naturally close before or shortly after birth. If a hole does not close on its own, it is called a septal defect.

The most common types of heart holes are called septal defects.

An atrial septal defect (ASD) is a hole in the septum between the two upper chambers of the heart; a ventricular septal defect (VSD) is a hole in the septum between the two lower chambers.

Normally, the left side of the heart pumps blood to the body, and the right side pumps blood to the lungs. With ASD or VSD, blood flows through the hole back to the lungs. Increased blood flow through the lungs can damage blood vessels in the lungs over time, which can lead to high blood pressure and heart failure in adulthood.

Small septal defects may go unnoticed if they cause no problems. Larger holes usually cause symptoms during the first few weeks of a child’s life and may require repair to prevent complications down the road.

“In most cases, we can use a catheter to place a plug into the hole to block it,” says Dr. Price. “Occasionally, some cases may require surgery to close the hole. With both procedures, the results are usually very successful.”