How Your Heart and Valves Work

You can think of your heart as your body’s engine, and your heart valves as the accelerator and brakes. The way your heart and its valves work, and why they sometimes need repair, is important to understand so that you can keep them working properly.

The human heart is a muscle about the size of a fist. It is made up of special cells that contract in rhythm, beating between 60 and 90 times a minute to pump blood throughout the body.

Your heart has two halves, left and right. Each half has two chambers, called the atrium and the ventricle, which work together in a life-sustaining cycle.

  • Oxygen-depleted blood from your body enters your heart through your right atrium and is sent to your right ventricle.
  • Your right ventricle pumps the blood to your lungs, where it is replenished with oxygen.
  • This oxygen-rich blood is then returned to your heart through your left atrium, and is then sent to your left ventricle.
  • Your left ventricle pumps the blood out of your heart, into the rest of your body through a large artery called the aorta, to nourish your organs (brain, kidneys, liver, etc) with oxygen.

Your Valuable Valves

Your veins and arteries are the “highways” for blood flow, but this flow is controlled by your heart’s four valves. They open and close in rhythm, and each has a vital role to play.

  • Your tricuspid valve controls blood flow from your right atrium to your right ventricle.
  • Your pulmonary valve allows blood to be pumped from your right ventricle to your lungs so it can be replenished with oxygen.
  • Your mitral valve controls blood flow from your left atrium to your left ventricle.
  • Your aortic valve allows this oxygen-rich blood to flow from your left ventricle to the rest of your body.

For your valves to work properly, they must remain flexible. Your heart valves need to be open completely in order for the right amount of blood to flow through, and they must close tightly so that blood doesn’t leak back into your heart chambers.

Problems with heart valves can be present since birth, or they can happen due to certain conditions such as high blood pressure, diabetes, kidney disease, having had rheumatic fever (a complication of untreated infections such as strep throat), a buildup of plaque due to high cholesterol, and other reasons.

Aortic Valve Problems

A common problem to affect the aortic valve is called aortic stenosis. It occurs when the aortic valve, which regulates the blood flow out of your heart, becomes narrow or obstructed. This causes your heart to work harder in order to send blood to the rest of your body.

Aortic stenosis may cause symptoms such as chest pain, faintness, dizziness, shortness of breath, fatigue, and a rapid heartbeat. Left untreated, it could lead to heart failure and death.

Fortunately, medical advances can now treat damaged or defective heart valves. For example, a procedure called transcatheter aortic valve replacement (TAVR) can be performed in cases of severe aortic stenosis to replace a damaged valve with a new one.

The TAVR procedure, while lifesaving, does carry some risks, including the risk of a stroke. During TAVR, tiny particles of plaque (called embolic debris) can break loose and travel through the bloodstream to become lodged in the brain, and potentially cause a stroke. But this risk can be minimized with a technique called Protected TAVR, which involves using a filter-like device to capture dangerous particles before they can reach the brain.

Understanding how your body’s ‘engine’ works, and what can be done if it needs new parts, can help you to partner with your doctor to keep your heart ticking for many years to come.