The Howard Gilman Institute for Valvular Heart Disease
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About Valvular Heart Disease


1. Overview

2. How Valves Work

3. Valve Diseases

4. Causes & Who's at Risk

5. Atrial Fibrillation


Causes of Valve Disease

Heart valve diseases are caused by:

  • hereditary (genetic) factors
    • congenital/structural heart malformations
    • abnormalities of the inner working of heart muscle cells in structurally normal hearts
  • rheumatic fever
  • bacterial infections such as infective endocarditis
  • changes resulting from the aging process

Currently, most valve diseases result from genetically-determined factors.

Who's at Risk

The real incidence of valve abnormalities among Americans is difficult to determine. However, a recent six-year survey indicates that the number of US hospital discharges resulting from heart valve diseases has grown substantially.

It is estimated that at least 15 million Americans have some type of heart valve abnormality while three to four million have disease severe enough to require surgery, at some time in their lives.

Prevalence of Valve Disease

A recent survey used echocardiography to detect valvular regurgitation (valves with closing problems) among 3,000 healthy people — ages 18 through 35 — who were not known to have valvular disease.

Among those tested, three and one-half percent had leaking heart valves. If this percentage were applied to the total number of Americans between the ages of 18 and 35, it would mean that 8.5 million people in this age range have valvular insufficiency.

This figure does not take into account Americans with severe and/or diagnosed disease. Nor does it factor in that valvular heart disease is more prevalent as people age. It also doesn’t include patients with stenotic disease (valves that don't open completely).

Valve Disease and an Aging Population

The federally-funded Framingham Heart Study was aimed at characterizing the prevalence, distribution and risk factors associated with heart disease in the United States. Its findings indicate that half of Americans over 70 years old have detectable heart valve disease.

Aortic stenosis is the most prevalent stenotic disease. Although some children have severe aortic stenosis, the disease usually develops between the ages of 50 and 80, worsening progressively with age.

As the Baby Boom generation ages, aortic stenosis will become a more serious public health problem.


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The Howard Gilman Institute for Heart Valve Disease