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Overview of Valvular Disorders

Rheumatic heart disease damage (inflames & scars) to valve apparatus ↑ Pulmonary blood pressure ↑ Age wear & tear deteriorating valve Pressure overload & pumping against ↑ resistance stretches & pulls apart valve leaflets Overview of all Valvular Disorders in the Context of the Cardiac Cycle Valvular Regurgitation ↑ Systemic blood pressure Pressure overload & pumping against ↑ resistance stretches & pulls apart valve leaflets Endocarditis (infection)** Authors: Catherine R Jarvis Reviewers: Omar El Ferri Shuvam Prasai Nicholas Samuelson Robert Miller* *MD at time of publication **See corresponding Calgary Guide slide(s) Aortic or mitral valve does not fully close Pulmonary or tricuspid valve does not fully close Aortic Regurgitation Mitral Regurgitation Blood flows back Blood flows back into into left ventricle left atrium in systole in diastole (ventricular (ventricular filling) contraction) Pulmonary Regurgitation Tricuspid Regurgitation Blood flows back into right ventricle in diastole (ventricular filling) Blood flows back into right atrium in systole (ventricular contraction) Notes: S1 – First heart sound & closure of atrioventricular valves (mitral & tricuspid) begins systole S2 – Second heart sound & closure of semilunar valves (aortic & pulmonary) begins diastole Early diastolic murmur after S2 Holosystolic (full systole) murmur Early diastolic murmur after S2 (↑ with inspiration) Holosystolic (full systole) murmur (↑ with inspiration) Valvular Stenosis Valvular Atresia Birth defect – valve not formed: solid tissue instead of open passage ↑ Age (especially >65yr) Valve leaflets calcify (harden) Genetic abnormalities (e.g., family history of heart defects, Down Syndrome) Maternal environmental factors (e.g., alcohol, smoking, diabetes, rubella virus) Aortic, pulmonary, mitral or tricuspid valve leaflets stiffen & thicken Aortic, pulmonary, mitral or tricuspid valve opening narrows Aortic, pulmonary, mitral or tricuspid valve leaflets fuse before birth Aortic Stenosis Pulmonary Stenosis Mitral Stenosis Tricuspid Stenosis Blood flow across Blood flow across Blood flow Blood flow Aortic Atresia Pulmonary Atresia Mitral Atresia Tricuspid Atresia aortic valve is pulmonary valve is across mitral across tricuspid No blood flows No blood flows No blood flows No blood flows hindered hindered valve is hindered valve is hindered from left from right from left from right ventricle to ventricle to atrium to left atrium to right aorta pulmonary trunk ventricle ventricle Blood flows turbulently across associated valve in systole (ventricular contraction) Blood flows turbulently across associated valve in diastole (ventricular filling) Loud single S2 Quiet S1 Loud S1 Mid-late-diastolic murmur Crescendo-decrescendo systolic murmur Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Feb 19, 2026 on www.thecalgaryguide.com Valvular birth defect Rheumatic heart disease Inflames & scars valve apparatus