Can CHD include problems with heart valves?
Yes, Congenital Heart Disease (CHD) frequently involves problems with the heart’s valves. In fact, valve defects are among the most common structural issues identified at birth. These problems occur when the valves the “doors” that keep blood flowing in the right direction through the heart do not form correctly during the first eight weeks of pregnancy. This can result in valves that are too narrow (stenosis), completely closed (atresia), or leaky (regurgitation).
Heart valve defects can occur in isolation or as part of more complex conditions like Tetralogy of Fallot or Hypoplastic Left Heart Syndrome. When a valve is faulty, the heart muscle must work significantly harder to pump blood, which can lead to heart enlargement and, if left untreated, heart failure. Modern UK cardiology offers highly successful treatments, ranging from keyhole balloon procedures to advanced surgical reconstructions that allow the valves to function effectively throughout a patient’s life.
What We’ll Discuss in This Article
- The four types of heart valves and their roles in circulation.
- Common congenital valve issues: Stenosis, Atresia, and Regurgitation.
- Detailed look at Bicuspid Aortic Valve (the most common valve defect).
- How valve problems affect the heart muscle (Hypertrophy).
- 2026 clinical data on the longevity of pediatric valve repairs.
- Treatment pathways from balloon valvuloplasty to valve replacement.
Types of Congenital Valve Defects
In a healthy heart, four valves (tricuspid, pulmonary, mitral, and aortic) ensure that blood flows in one direction. In CHD, any of these valves can be malformed. Clinicians generally categorize these defects into three mechanical categories based on how they obstruct or alter blood flow.
The following table outlines the primary ways valves can be affected by CHD:
| Defect Type | Description | Clinical Result |
| Stenosis | The valve is too narrow or stiff. | The heart must pump under high pressure to force blood through. |
| Atresia | The valve is completely closed or missing. | Blood cannot follow its normal path; requires a “shunt” or hole to bypass. |
| Regurgitation | The valve does not close tightly (leaky). | Blood flows backward, causing the heart chambers to stretch and enlarge. |
Common Valve Conditions in CHD
Some valve problems are so common that they are considered “signature” CHD defects. The most prevalent is the Bicuspid Aortic Valve (BAV). While a normal aortic valve has three leaflets (flaps), a bicuspid valve only has two. This can cause the valve to wear out faster, leading to narrowing or leaking later in life. BAV affects approximately 1% to 2% of the entire population, making it the most frequent of all congenital heart anomalies.
Other significant valve-related CHD includes:
- Pulmonary Stenosis: A narrowing of the valve leading to the lungs, often successfully treated with a balloon.
- Ebstein’s Anomaly: A misplaced and leaky tricuspid valve on the right side of the heart.
- Tricuspid Atresia: A missing valve on the right side, which is a type of “single-ventricle” defect.
- Mitral Valve Prolapse/Cleft: Issues with the valve on the left side, often seen in children with Down’s syndrome (AVSD).
Hemodynamic Impact: Why Valve Health Matters
When a valve is stenotic (narrow), the heart chamber behind it must generate massive pressure to move blood. This causes the heart muscle to thicken, a condition known as hypertrophy. While the heart can handle this extra work for a while, a muscle that is too thick eventually becomes “stiff” and less efficient at pumping.
Conversely, a regurgitant (leaky) valve causes the heart chambers to become overloaded with volume. This “volume overload” causes the heart to stretch out (dilation). If the chambers stretch too much, they can lose their “spring,” leading to heart failure. This is why cardiologists use regular echocardiograms to monitor the exact millimetre-measurements of the heart chambers in patients with valve-related CHD.
To Summarise
Congenital Heart Disease very often includes problems with heart valves. These defects ranging from narrowings to complete closures disrupt the “one-way” flow of blood, putting the heart muscle under significant pressure or volume strain. While valve issues are serious, they are highly treatable. Through early diagnosis via fetal or newborn scans and modern surgical repairs that prioritize the use of the child’s own tissue, the vast majority of children with valve-related CHD grow up to lead healthy, active lives.
If your baby has blue-tinged lips, is struggling to breathe, or becomes very sweaty during feeding, call 999 immediately.
If you or your child experience sudden chest pain or faint during physical activity, call 999 immediately.
You may find our free BMI Calculator helpful for monitoring general growth milestones, which is an important indicator of heart efficiency in children with valve defects.
Can a leaky heart valve fix itself?
Mild leaks (regurgitation) can sometimes remain stable for years without needing treatment, but structural valve defects rarely “fix” themselves and usually require monitoring.
What is a ‘balloon valvuloplasty’?
It is a keyhole procedure where a cardiologist uses a balloon to stretch open a narrow valve (stenosis) without needing open-heart surgery.
Why does my child need antibiotics before the dentist?
For certain complex valve defects, antibiotics are recommended to prevent “endocarditis,” an infection of the heart valve that can occur when bacteria enter the bloodstream during dental work.
Is a bicuspid aortic valve dangerous?
Many people with BAV live healthy lives without knowing they have it, but it can lead to problems like narrowing or an enlarged aorta in adulthood, so it does require regular check-ups.
What is valve ‘atresia’?
Atresia means the valve never formed or is completely blocked, meaning no blood can pass through that route at all.
Can heart valve problems be seen on a pregnancy scan?
Yes, major valve issues are usually visible during the 20-week anomaly scan, and a detailed fetal echocardiogram can provide more specific measurements.
How long do artificial heart valves last?
Mechanical valves can last a lifetime but require blood-thinning medication. Biological (tissue) valves usually last 10 to 15 years before needing to be replaced.
Authority Snapshot (E-E-A-T Block)
This article was reviewed by Dr. Stefan Petrov, a UK-trained physician (MBBS) with postgraduate certifications in ACLS and BLS. Dr. Petrov has extensive clinical experience in general medicine and emergency care, having worked in hospital wards and intensive care units where the management of valve-related heart failure is a critical focus. His expertise ensures this information on congenital valve defects is accurate, safe, and aligned with current NHS and British Cardiovascular Society (BCS) standards.
