Heart Valve Disease: Symptoms, Causes & Treatment Options

What Are the Different Types of Heart Valve Disease?

Heart valve disease is categorized into two main types: stenosis (narrowing of the valve) and regurgitation (valve leakage). These problems can affect any of the heart's four valves—aortic, mitral, tricuspid, or pulmonary—though the aortic and mitral valves on the left side of the heart are most commonly affected due to the higher pressures they experience.

The heart functions as a sophisticated pump with four chambers and four valves working in precise coordination. Each valve acts as a one-way door, opening to allow blood flow and closing tightly to prevent backflow. When valves malfunction, the heart must work harder to maintain adequate circulation, eventually leading to symptoms and potential complications.

Understanding the different types of valve problems is essential for both diagnosis and treatment planning. The severity of symptoms often correlates with how much the valve dysfunction affects overall heart function, though this relationship is not always straightforward. Some patients with severe valve disease may have minimal symptoms, while others with moderate disease may be significantly affected.

Valve disease can be congenital (present from birth) or acquired later in life. Acquired valve disease may result from aging and calcium deposits, infections, rheumatic fever, or other conditions that damage valve tissue. The specific type and cause of valve disease influence treatment decisions and long-term outlook.

Valve Stenosis

Stenosis occurs when a valve becomes narrowed or stiffened, restricting blood flow through the opening. This forces the heart to pump harder to push blood through the narrowed valve. Over time, this increased workload can cause the heart muscle to thicken and eventually weaken.

Aortic stenosis is the most common valve disease in adults, particularly those over age 65. It often develops from calcification—the gradual buildup of calcium deposits on the valve leaflets that causes them to stiffen and narrow. Some people are born with a bicuspid aortic valve (two leaflets instead of three), which predisposes them to earlier stenosis development.

Mitral stenosis is less common in developed countries but remains prevalent where rheumatic fever occurs. Rheumatic heart disease, caused by untreated streptococcal throat infections, can cause scarring and fusion of the mitral valve leaflets, resulting in stenosis that typically develops years after the initial infection.

Valve Regurgitation

Regurgitation (also called insufficiency or incompetence) occurs when a valve doesn't close completely, allowing blood to leak backward. This means the heart must pump more blood with each beat to compensate for the backflow, increasing its workload.

Mitral regurgitation is the most common form of valve leakage. It can result from mitral valve prolapse (where valve leaflets bulge into the left atrium), damage from heart attack, infection, or age-related degeneration of the valve structure. The severity can range from mild (causing no symptoms) to severe (requiring surgical intervention).

Aortic regurgitation allows blood to flow backward from the aorta into the left ventricle. Causes include bicuspid aortic valve, aortic root dilation, endocarditis, or damage from conditions like Marfan syndrome. Like other valve diseases, it may progress slowly over years.

Mixed Valve Disease

Some patients have both stenosis and regurgitation affecting the same valve, known as mixed or combined valve disease. Additionally, multiple valves can be affected simultaneously, particularly in patients with rheumatic heart disease or certain genetic conditions. These complex cases require careful evaluation to determine the optimal treatment approach.

What Are the Symptoms of Heart Valve Disease?

The most common symptoms of heart valve disease include shortness of breath (especially during activity or when lying down), unusual fatigue and weakness, chest pain or discomfort, heart palpitations, dizziness or fainting, and swelling in the ankles, feet, or abdomen. Many people have no symptoms in early stages, and the condition is often first detected when a doctor hears a heart murmur during examination.

Heart valve disease often develops gradually over many years, and many patients initially experience no symptoms at all. This silent progression is one reason why regular medical checkups are important, particularly for those with known risk factors or a family history of heart disease. A heart murmur—an unusual sound heard through a stethoscope caused by turbulent blood flow—is frequently the first indication of valve disease.

When symptoms do develop, they typically reflect the heart's decreasing ability to pump blood efficiently. The specific symptoms and their severity depend on which valve is affected, the type of dysfunction (stenosis or regurgitation), how severe the problem is, and how quickly it has developed. Symptoms that appear suddenly may indicate acute valve damage from conditions like heart attack or infection.

It's important to recognize that some people adapt to slowly developing symptoms without realizing it. They may unconsciously reduce their activity level to avoid symptoms, leading them to believe they feel fine when their exercise tolerance has actually declined significantly. This adaptation can mask the true severity of valve disease.

Breathing Difficulties

Shortness of breath is the most common symptom of heart valve disease. Initially, it may only occur during physical exertion or exercise. As the condition progresses, breathing difficulties may occur with less activity and eventually at rest. Many patients also experience orthopnea—difficulty breathing when lying flat—and may need to prop themselves up with pillows to sleep comfortably.

Paroxysmal nocturnal dyspnea, where patients wake suddenly at night gasping for air, is a concerning symptom that suggests fluid accumulation in the lungs. This typically improves after sitting up or standing for several minutes. Any sudden worsening of breathing symptoms warrants prompt medical attention.

Fatigue and Weakness

Reduced exercise tolerance and unusual tiredness are common early symptoms. Patients may notice they tire more easily during activities that previously caused no difficulty. This fatigue results from the heart's reduced ability to deliver oxygen-rich blood to muscles and organs efficiently.

The fatigue associated with heart valve disease differs from normal tiredness—it's often disproportionate to the level of activity and may not improve fully with rest. Some patients describe a general sense of weakness or feeling "run down" that persists despite adequate sleep.

Heart-Related Symptoms

Heart palpitations—awareness of the heart beating, racing, or skipping beats—are common with valve disease. These may result from the heart working harder or from arrhythmias (abnormal heart rhythms) that can develop as a complication of valve dysfunction. Atrial fibrillation is particularly common with mitral valve disease.

Chest pain or discomfort may occur, particularly with aortic stenosis. This pain, called angina, happens when the heart muscle doesn't receive enough blood flow to meet its needs. It typically occurs during exertion and improves with rest. Chest pain should always be evaluated promptly by a healthcare provider.

Dizziness and Fainting

Dizziness and fainting (syncope) are serious symptoms that warrant immediate medical attention. With severe aortic stenosis in particular, fainting during exertion indicates that the heart cannot increase blood flow adequately to meet the body's demands. These symptoms are associated with increased risk and often indicate the need for surgical intervention.

Swelling

Swelling in the ankles, feet, and legs (peripheral edema) occurs when the heart cannot pump blood effectively, causing fluid to accumulate in the lower extremities. In more advanced cases, abdominal swelling (ascites) may develop from fluid accumulation in the abdomen. Weight gain from fluid retention may be noticed even before visible swelling appears.

• Shortness of breath: During activity, lying flat, or at rest as condition progresses
• Fatigue: Unusual tiredness and reduced exercise tolerance
• Palpitations: Racing, fluttering, or irregular heartbeat
• Chest pain: Discomfort during exertion, especially with aortic stenosis
• Dizziness/fainting: Particularly during or after physical activity
• Swelling: In ankles, feet, legs, or abdomen
• Heart murmur: Abnormal sound detected by doctor during examination

When Should You See a Doctor for Heart Valve Problems?

See a doctor if you experience increasing shortness of breath, unexplained fatigue, chest discomfort, or heart palpitations. Seek emergency care immediately if you have severe chest pain lasting more than 15 minutes, sudden severe difficulty breathing, or fainting. Anyone with known valve disease should have regular follow-up appointments as recommended by their cardiologist.

Recognizing when to seek medical care for potential heart valve problems can be challenging because symptoms often develop gradually. Many people dismiss early symptoms as normal aging or being out of shape. However, early detection and monitoring of heart valve disease is important for optimal outcomes, as treatment can be timed to prevent irreversible heart damage.

If you have known heart valve disease, maintaining regular follow-up appointments is essential. Your cardiologist will monitor the progression of your condition and help determine the optimal timing for any interventions. Even if you feel well, objective tests may reveal changes that influence treatment decisions.

For those without known valve disease, being aware of potential symptoms and seeking evaluation when they occur can lead to earlier diagnosis. A primary care doctor can perform an initial assessment and refer you to a cardiologist if valve disease is suspected.

Non-Emergency Symptoms Requiring Medical Evaluation

Schedule an appointment with your doctor if you notice any of the following symptoms developing or worsening: increased shortness of breath with activities that previously didn't cause problems, unusual fatigue that doesn't improve with rest, heart palpitations that are new or more frequent, mild chest discomfort during exertion, or swelling in your ankles or feet.

If a doctor has previously detected a heart murmur, discuss the recommended frequency of follow-up evaluations. Some murmurs are benign (innocent murmurs), but others indicate valve abnormalities that require monitoring or treatment. Don't assume a murmur mentioned years ago is unimportant—conditions can progress over time.

Regular Monitoring

Once heart valve disease is diagnosed, regular monitoring helps ensure timely intervention. The frequency of follow-up depends on the severity of the condition. Mild valve disease may only require evaluation every few years, while moderate to severe disease typically requires more frequent monitoring, often annually or more often.

What Causes Heart Valve Disease?

Heart valve disease can be caused by congenital defects (present from birth), age-related degeneration and calcification, rheumatic fever, infections (endocarditis), heart attacks, and conditions that affect connective tissue. High blood pressure and high cholesterol may accelerate valve deterioration. Risk increases with age, with valve disease affecting approximately 13% of people over 75 years old.

Understanding the causes of heart valve disease helps both in prevention and treatment planning. While some causes cannot be prevented, others are linked to modifiable risk factors or treatable conditions. The underlying cause often influences which type of valve disease develops and how it progresses.

In developed countries, degenerative valve disease related to aging has become the most common cause as rheumatic heart disease has declined. However, rheumatic heart disease remains a leading cause of valve disease in many parts of the world where streptococcal infections are not promptly treated with antibiotics.

Age-Related Degeneration

As we age, heart valves undergo wear and changes. Calcium deposits can accumulate on valve leaflets, causing them to stiffen and narrow (stenosis). The valve tissue may also weaken and stretch, preventing proper closure (regurgitation). These degenerative changes are the most common cause of valve disease in older adults.

Aortic stenosis from calcific degeneration typically develops after age 65 in those with normal three-leaflet valves, though it can occur earlier in those with bicuspid aortic valves. Mitral valve prolapse and regurgitation are also largely degenerative conditions, though they can occur at any age.

While aging itself cannot be prevented, some factors may accelerate degenerative changes. There appears to be an association between traditional cardiovascular risk factors—high blood pressure, high cholesterol, diabetes, and smoking—and more rapid progression of calcific aortic stenosis, though this relationship is still being studied.

Congenital Valve Defects

Some people are born with abnormal heart valves. The most common congenital valve abnormality is a bicuspid aortic valve, where the valve has two leaflets instead of the normal three. This occurs in approximately 1-2% of the population and predisposes to earlier development of aortic stenosis or regurgitation.

Other congenital valve abnormalities include malformed pulmonary or tricuspid valves, which may be part of more complex congenital heart conditions. These defects may be detected at birth or may not cause symptoms until later in life.

Rheumatic Heart Disease

Rheumatic fever, caused by untreated streptococcal throat infections (strep throat), can damage heart valves. The body's immune response to the infection can cause inflammation of the heart, leading to scarring of the valves. This damage may not become apparent until years or decades after the initial infection.

Rheumatic heart disease most commonly affects the mitral valve, causing stenosis, regurgitation, or both. Multiple valves are often affected. While rheumatic fever is now rare in developed countries due to antibiotic treatment of strep infections, it remains a significant cause of valve disease globally.

Infective Endocarditis

Infective endocarditis is an infection of the heart valves caused by bacteria (or rarely, fungi) entering the bloodstream. The infection can damage valve tissue, causing regurgitation, or lead to growths (vegetations) on the valves that can break off and cause strokes or other complications.

People with existing valve abnormalities or prosthetic valves are at higher risk for endocarditis. Good dental hygiene is important for reducing risk, as bacteria from the mouth can enter the bloodstream during dental procedures or even routine brushing if gums are diseased.

Other Causes

Heart attacks can damage the heart muscle and structures that support the mitral valve, leading to mitral regurgitation. Some medications (certain weight-loss drugs and migraine medications) have been associated with valve disease. Radiation therapy to the chest for cancer treatment can also damage heart valves years later.

Connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome can affect valve structure and function. Autoimmune conditions, including lupus and rheumatoid arthritis, may also affect the heart valves.

How Is Heart Valve Disease Diagnosed?

Heart valve disease is primarily diagnosed using echocardiography (heart ultrasound), which shows valve structure and blood flow. The diagnostic process typically begins when a doctor detects a heart murmur during physical examination. Additional tests may include ECG (electrocardiogram), chest X-ray, cardiac catheterization, and exercise stress testing to assess severity and guide treatment decisions.

The diagnosis of heart valve disease often begins with a routine physical examination when a healthcare provider detects a heart murmur using a stethoscope. Heart murmurs are sounds created by turbulent blood flow, which can occur when blood flows through a narrowed or leaking valve. However, not all murmurs indicate valve disease—many are benign, particularly in children and young adults.

When valve disease is suspected, a series of tests helps confirm the diagnosis, determine which valve is affected, assess severity, and evaluate the impact on heart function. This comprehensive evaluation guides treatment decisions and helps establish a monitoring schedule.

Heart Murmurs

A heart murmur is often the first clue to valve disease. Doctors can gain significant information from the characteristics of a murmur—its location, timing (during contraction or relaxation of the heart), loudness, and quality. Different valve problems produce characteristic murmur patterns that experienced clinicians can often identify.

However, murmurs alone cannot determine the severity of valve disease or guide treatment. Imaging and other tests are necessary for a complete assessment. Some significant valve disease may not produce loud murmurs, while some loud murmurs may come from relatively minor abnormalities.

Echocardiography

Echocardiography is the cornerstone of valve disease diagnosis. This non-invasive test uses ultrasound waves to create detailed images of the heart in real-time. It allows doctors to see the heart valves open and close, assess their structure and movement, and measure blood flow through them.

A standard echocardiogram is performed by placing the ultrasound probe on the chest wall (transthoracic echocardiogram or TTE). For more detailed images of the valves, particularly before surgery, a transesophageal echocardiogram (TEE) may be performed. In this test, a specialized probe is passed down the esophagus (food pipe), which lies directly behind the heart, providing clearer images.

Echocardiography provides crucial information including: valve structure and any abnormalities, severity of stenosis (how narrow the valve opening is), severity of regurgitation (how much blood leaks backward), heart chamber sizes (enlarged chambers may indicate chronic valve problems), heart muscle function (how well the heart pumps), and estimated pressures within the heart and lungs.

Electrocardiogram (ECG)

An ECG records the heart's electrical activity and can reveal abnormalities associated with valve disease. These may include irregular heart rhythms like atrial fibrillation, signs of enlarged heart chambers, and evidence of strain on the heart muscle. While ECG cannot directly diagnose valve disease, it provides complementary information useful for management.

Chest X-Ray

A chest X-ray can show changes in heart size and shape, calcium deposits on heart valves, and signs of fluid in the lungs from heart failure. While less specific than echocardiography, chest X-rays remain useful as part of the overall evaluation.

Exercise Testing

Stress testing (exercise testing) may be performed to evaluate how the heart responds to physical activity. This is particularly useful for patients who report few symptoms but whose valve disease appears significant on echocardiography. Some patients have unconsciously limited their activity and may demonstrate reduced exercise capacity on formal testing.

Stress echocardiography combines exercise testing with echocardiographic imaging, allowing assessment of how the valve and heart function change with exertion.

Cardiac Catheterization

Cardiac catheterization involves threading thin tubes (catheters) through blood vessels to the heart. This allows direct measurement of pressures in the heart chambers and blood vessels. It's often performed before valve surgery to check for coronary artery disease that might be addressed simultaneously.

Catheterization can also provide accurate assessment of valve severity when echocardiographic findings are inconclusive or discordant with symptoms. The procedure carries small risks and is typically reserved for cases where the information is needed for treatment decisions.

How Is Heart Valve Disease Treated?

Treatment for heart valve disease depends on severity and symptoms. Options include regular monitoring for mild cases, medications to manage symptoms and protect heart function, and surgical intervention (valve repair or replacement) for severe disease. Modern procedures include both traditional open-heart surgery and minimally invasive approaches like TAVR (transcatheter aortic valve replacement). With appropriate treatment, most patients achieve excellent outcomes.

The approach to treating heart valve disease is highly individualized, based on factors including the type and severity of valve dysfunction, presence and severity of symptoms, overall heart function, age, and other health conditions. The goal is to maintain quality of life and prevent irreversible damage to the heart.

For many patients with mild to moderate valve disease, a strategy of regular monitoring ("watchful waiting") is appropriate, with intervention reserved for when the condition worsens. This approach is based on evidence that surgery too early in the disease course doesn't improve outcomes and exposes patients to procedural risks unnecessarily.

When intervention becomes necessary, the choice between repair and replacement—and the type of replacement valve—involves careful consideration of many factors. These decisions are best made through shared decision-making between patients and their heart team, including cardiologists and cardiac surgeons.

Monitoring and Lifestyle Measures

Regular monitoring with echocardiography tracks disease progression and helps determine optimal timing for intervention. The frequency of monitoring depends on severity—annual or more frequent for moderate to severe disease, less often for mild disease.

While lifestyle measures cannot reverse valve disease, they may help slow progression and maintain overall cardiovascular health. Recommendations include controlling blood pressure (high blood pressure puts additional stress on the heart), maintaining healthy cholesterol levels, not smoking (smoking accelerates cardiovascular disease), eating a heart-healthy diet, maintaining a healthy weight, staying physically active as tolerated (discuss exercise recommendations with your doctor), and practicing good dental hygiene to reduce endocarditis risk.

Medications

Medications cannot cure valve disease but can help manage symptoms and protect heart function. Commonly used medications include diuretics (water pills) to reduce fluid accumulation and relieve symptoms like swelling and shortness of breath, blood pressure medications to reduce the workload on the heart, antiarrhythmic medications to control irregular heart rhythms like atrial fibrillation, and anticoagulants (blood thinners) to prevent blood clots, particularly in patients with atrial fibrillation or mechanical valve prostheses.

For some patients with heart failure from valve disease, medications that help the heart pump more effectively may be prescribed. The specific medications used depend on the type of valve disease and associated conditions.

Valve Repair

Valve repair preserves the patient's own valve tissue while correcting the dysfunction. When possible, repair is generally preferred over replacement because it avoids the need for lifelong anticoagulation required with mechanical valves and avoids the durability limitations of biological valves.

Mitral valve repair is often possible for mitral regurgitation and has excellent long-term results in experienced centers. The surgeon may reshape the valve leaflets, repair or replace supporting structures (chordae), or place a ring around the valve to restore proper function.

Aortic valve repair is less commonly performed but may be an option in selected patients, particularly those with regurgitation from aortic root disease. Repair techniques continue to evolve.

Valve Replacement

When repair isn't feasible, valve replacement becomes necessary. The diseased valve is removed and replaced with a prosthetic valve. There are two main types of replacement valves, each with advantages and disadvantages.

Mechanical valves are made from durable materials (carbon and metal) and last a lifetime. However, they require lifelong anticoagulation therapy with warfarin to prevent blood clots from forming on the valve. This necessitates regular blood testing and careful management. Mechanical valves also produce an audible click that some patients notice.

Biological (tissue) valves are made from animal tissue (usually pig or cow) or human donor tissue. They don't require lifelong anticoagulation (unless needed for other reasons like atrial fibrillation). However, they have limited durability, typically lasting 10-20 years before requiring replacement. Younger patients may outlive their biological valve and need repeat surgery.

The choice between mechanical and biological valves involves weighing longevity against the burden of anticoagulation, considering factors like age, lifestyle, ability to take anticoagulants safely, and patient preferences.

Minimally Invasive and Catheter-Based Procedures

Advances in technology have made less invasive approaches possible for many patients. Transcatheter aortic valve replacement (TAVR, also called TAVI) involves implanting a new valve through a catheter, usually inserted through an artery in the leg. Originally developed for patients too high-risk for open surgery, TAVR is now an option for many patients with aortic stenosis, including those at intermediate or even low surgical risk.

Balloon valvuloplasty uses a catheter-delivered balloon to open a narrowed valve. For aortic stenosis in adults, this provides only temporary relief and is mainly used as a bridge to more definitive treatment. For mitral stenosis (particularly from rheumatic disease), balloon valvuloplasty can provide durable results in appropriate candidates.

Catheter-based mitral valve repair (MitraClip) clips the mitral valve leaflets together to reduce regurgitation. This option is available for patients with severe mitral regurgitation who are high-risk for surgery.

After Surgery

Recovery after valve surgery varies based on the procedure. Traditional open-heart surgery typically requires about a week of hospitalization followed by several weeks to months of recovery at home. Many patients participate in cardiac rehabilitation programs to help regain strength and confidence.

Patients with mechanical valves need lifelong anticoagulation with warfarin and regular blood testing (INR monitoring). Those with biological valves may need anticoagulation only for a short period after surgery.

All patients with prosthetic valves need antibiotic prophylaxis before certain dental and medical procedures to prevent endocarditis. Regular follow-up with echocardiography monitors valve function over time.

How Do Heart Valves Work?

The heart has four valves that act as one-way doors, ensuring blood flows in the correct direction through the heart's chambers. The mitral and tricuspid valves (atrioventricular valves) control flow between the upper and lower chambers, while the aortic and pulmonary valves (semilunar valves) control flow out of the heart to the body and lungs. Each heartbeat involves precisely timed opening and closing of these valves.

Understanding how normal heart valves function helps explain why valve disease causes problems. The heart is essentially a muscular pump divided into four chambers: two upper chambers (atria) that receive blood, and two lower chambers (ventricles) that pump blood out. The right side handles blood returning from the body and pumps it to the lungs; the left side receives oxygenated blood from the lungs and pumps it to the body.

The four heart valves ensure that blood flows forward through this system, opening to allow blood passage and closing to prevent backflow. This coordinated action occurs approximately 100,000 times daily—roughly 2.5 billion times over a 70-year lifespan.

The Atrioventricular Valves

The tricuspid valve (on the right side) and mitral valve (on the left side) separate the atria from the ventricles. These valves open when the atria contract, allowing blood to flow into the ventricles. They then close when the ventricles contract, preventing blood from flowing backward into the atria.

The mitral valve has two leaflets (hence sometimes called the bicuspid valve), while the tricuspid valve has three leaflets. These leaflets are attached to the heart muscle by fibrous cords called chordae tendineae, which prevent the leaflets from prolapsing backward when the ventricles contract.

The Semilunar Valves

The pulmonary valve controls blood flow from the right ventricle to the pulmonary artery (going to the lungs), while the aortic valve controls flow from the left ventricle to the aorta (going to the body). Both valves have three crescent-shaped leaflets (cusps).

These valves open when the ventricles contract, allowing blood to be ejected. When the ventricles relax, blood in the arteries tries to flow backward, filling the leaflet cusps and causing them to snap shut. This creates the characteristic "lub-dub" heart sounds heard through a stethoscope.

The Cardiac Cycle

Each heartbeat involves a carefully orchestrated sequence. First, the atria contract, pushing blood through the open mitral and tricuspid valves into the ventricles. Then the ventricles contract; the mitral and tricuspid valves close (first heart sound, "lub"), and as pressure builds, the aortic and pulmonary valves open, ejecting blood into the arteries. When the ventricles relax, the aortic and pulmonary valves close (second heart sound, "dub"), and the cycle begins again.

When valves malfunction—whether by not opening fully (stenosis) or not closing properly (regurgitation)—this efficient system is disrupted. The heart must work harder to compensate, and over time, this increased workload can lead to heart enlargement, weakened heart muscle, and heart failure.

Can Heart Valve Disease Be Prevented?

While some causes of heart valve disease cannot be prevented (such as congenital defects and age-related degeneration), you can reduce risk by promptly treating strep throat infections to prevent rheumatic fever, maintaining good cardiovascular health through blood pressure and cholesterol control, not smoking, and practicing good dental hygiene to reduce endocarditis risk.

Prevention strategies for heart valve disease depend largely on the underlying causes. Some factors, like genetic conditions and aging, cannot be changed. However, several preventive measures can reduce the risk of certain types of valve disease or slow the progression of existing conditions.

Preventing Rheumatic Heart Disease

Rheumatic heart disease, once a leading cause of valve problems worldwide, can be prevented by promptly treating streptococcal throat infections with antibiotics. This remains particularly important in regions where rheumatic fever is common. If you or your child has symptoms of strep throat (severe sore throat, fever, swollen lymph nodes), seek medical evaluation for possible antibiotic treatment.

Cardiovascular Risk Factor Management

While the relationship between traditional cardiovascular risk factors and valve disease is still being studied, maintaining good cardiovascular health is sensible. This includes managing high blood pressure, as chronic hypertension puts stress on the heart and may accelerate valve deterioration. Control cholesterol levels through diet, exercise, and medications if prescribed. Don't smoke, as smoking damages blood vessels and accelerates cardiovascular disease. Maintain a healthy weight and stay physically active.

Preventing Endocarditis

Infective endocarditis is a serious infection of heart valves that can cause severe damage. People at highest risk include those with existing valve disease, prosthetic valves, or certain congenital heart conditions. Prevention measures include practicing good dental hygiene (brush and floss regularly, see a dentist regularly), avoiding behaviors that increase infection risk (such as intravenous drug use), and taking prophylactic antibiotics before certain dental or medical procedures if you're in a high-risk group.

The guidelines for antibiotic prophylaxis have become more selective in recent years. Not everyone with valve disease needs antibiotics before dental procedures. Discuss with your cardiologist whether you need prophylaxis and for which procedures.