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Heart valve disease

Murmurs, leaky valves and what the words mean

Most valve findings are mild, and mild findings very often stay that way and cause no symptoms at all — the words on a report sound far worse than the finding usually is. What decides whether a valve problem matters is how severe it is and how the heart is coping with it, which is what grading and follow-up are for. A murmur or a “leaky valve” is a reason to understand the finding, not a diagnosis of danger by itself.

Heart valves are flexible gates that keep blood moving in the intended direction. A murmur is a sound heard with a stethoscope; it can be innocent, or it can be a clue that an echocardiogram should describe a valve in more detail.

Valve explorer

Select a valve and a finding. The picture changes the highlighted valve and the explanation below it.

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Aortic valve: what it does.

Aortic valve selected A simplified heart diagram highlighting the aortic valve and showing forward flow.

Aortic valve

The aortic valve opens when the main pumping chamber sends blood out to the body, then closes so blood does not wash back into the heart.

A report may grade the valve as normal, mildly abnormal, moderate or severe. Mild findings are usually watched rather than treated.

How reports grade valve findings

An echocardiogram usually describes which valve is involved, whether the problem is narrowing, leaking or both, and how severe it looks. Trivial or mild leaking is often an incidental finding, especially when the heart size and pumping function are otherwise reassuring.

Severity matters because it changes the meaning of the words. Mild valve disease is usually monitored over time; severe valve disease is assessed more closely, especially if symptoms, heart size or heart function have changed.

Symptoms that change the picture

Breathlessness, chest tightness on exertion, blackouts, fainting, or feeling acutely unwell can make a valve finding more urgent.

Use emergency care now for chest tightness, severe breathlessness, fainting, blackouts, or feeling acutely unwell; use NHS 111 today for new or worsening symptoms that are not happening now, and your GP for planned follow-up when symptoms are absent or unchanged.

What usually happens next

The next step depends on the whole report, not the label alone. Clinicians look at the valve, the direction of blood flow, heart chamber size, heart pumping function, blood pressure, rhythm and symptoms together.

A page cannot tell you whether your valve needs treatment. It can help you ask clearer questions: which valve is involved, is it narrowing or leaking, how severe is it, has it changed, and what follow-up is planned?

Evidence behind this page

Valve guidance is built around symptoms, examination, echocardiography, severity grading and follow-up. The important point for a reader is that a mild word on a report and a dangerous valve problem are not the same thing.

Source: Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal. 2025;46(44):4635-4736. doi:10.1093/eurheartj/ehaf194.

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