- The tricuspid valve, between the right atrium and the right ventricle.
- The pulmonary valve, between the right ventricle and the pulmonary artery.
- The mitral valve, between the left atrium and the left ventricle.
- The aortic valve, between the left ventricle and the aorta.
The two most common valvular disorders in older adults are aortic stenosis and mitral regurgitation. The symptoms of valvular disorders vary depending on which valve is affected as well as on the type and severity of the change. Mild changes may cause no symptoms; a heart murmur — detected when the heart is examined with a stethoscope — is often the first sign of valve damage. In aortic stenosis, however, exertion can cause chest pain (known as "angina") or a feeling of tightness in the chest, shortness of breath, fainting or heart palpitations. Sudden death in otherwise healthy athletes is sometimes caused by aortic stenosis. Regurgitation can also cause detectable symptoms, such as shortness of breath or wheezing when lying down; these complaints may be intensified by exercise, increased resistance to breathing and immersion.
Treatment for valvular disorders generally involves surgery. Defective valves may be either repaired or replaced by prosthetic valves.
Preventing valvular damage is, of course, the best approach. Routine physical exams may uncover evidence of early valvular disease. In such cases, close, regular medical surveillance is advised to identify, and hopefully slow, progression of the damage.