A leaky heart valve occurs when a heart valve doesn’t close properly, allowing blood to flow backward. During pregnancy, this condition can affect circulation and increase strain on your heart.

A leaky heart valve happens when the valve does not close properly, causing blood to flow backward. This backflow, called regurgitation, can put extra strain on your heart. The strain can increase even more during pregnancy when your blood volume increases.

Mild regurgitation is usually not a concern. However, severe cases may cause symptoms like shortness of breath or swelling, requiring careful monitoring and treatment for a safe pregnancy.

This article discusses leaky heart valves and pregnancy, including symptoms, diagnosis, possible treatment options, and more.

A leaky heart valve, also called valve regurgitation, can put extra strain on your heart during pregnancy. Your heart works harder as your blood volume increases to support the baby.

If your heart valve doesn’t close properly, some blood flows backward, making circulation less effective. This can lead to symptoms such as fatigue, shortness of breath, or swelling.

However, in severe cases, a leaky heart valve can increase the risk of complications, including heart failure, requiring close medical monitoring.

According to a 2024 review, several types of heart valve conditions in pregnancy may occur, such as:

  • Mitral valve regurgitation: In this condition, the mitral valve doesn’t close fully, allowing blood to leak back into the left atrium. Mild cases are often manageable, but severe cases may need medication or monitoring.
  • Aortic valve regurgitation: In this condition, blood leaks back into the left ventricle instead of moving forward. This can cause the heart to enlarge and increase strain, especially during pregnancy.
  • Tricuspid valve regurgitation: This condition affects the right side of the heart, allowing blood to leak into the right atrium. It’s usually mild but can worsen if there are other heart problems.
  • Pulmonary valve regurgitation: In this condition, blood leaks back into the right ventricle from the pulmonary artery. While it is often linked to congenital heart conditions, pregnancy may make symptoms worse.

Pregnancy puts extra strain on your heart and blood vessels to support you and your baby. As a result, your body goes through several cardiovascular changes, including:

  • Increased blood volume: Your body produces up to 50% more blood to supply oxygen and nutrients to your baby, increasing your heart’s workload.
  • Changes in heart rate and blood pressure: Your heart rate increases by 10 to 20 beats per minute, while your blood pressure may drop in early pregnancy and rise later.
  • Hormonal changes: Pregnancy hormones like progesterone relax blood vessels and improve blood flow but sometimes cause dizziness and low blood pressure.
  • Higher cardiac output: The heart pumps more blood per minute, boosting circulation by up to 40% throughout pregnancy.
  • Increased risk of blood clots: A higher number of clotting factors reduces bleeding risks but increases the chances of deep vein thrombosis (DVT) or pulmonary embolism (PE).

Symptoms of a leaky heart valve can vary depending on the severity of the regurgitation and how well your heart adapts to pregnancy.

Common symptoms include:

  • shortness of breath, especially when lying down
  • fatigue and weakness
  • heart palpitations or irregular heartbeat
  • swelling in the feet, ankles, or legs
  • dizziness or fainting episodes
  • chest pain or discomfort (in severe cases)

If these symptoms worsen or appear suddenly, seek medical help immediately, as they may indicate increased heart strain or heart failure, putting you and your baby at risk.

Certain factors can increase the risk of complications from a leaky heart valve during pregnancy, including:

If you have these risk factors, your healthcare team may recommend specialized prenatal care to monitor your heart health and ensure a safe pregnancy.

Diagnosing a leaky heart valve involves several steps. A doctor will review your medical history, assess symptoms, and listen for atypical heart sounds that may indicate valve regurgitation.

They will then perform an echocardiogram, a common test that uses ultrasound waves to create images of the heart’s structure and function. It helps doctors see how the heart valves move and whether blood is leaking backward.

Your doctor may order an electrocardiogram (EKG) to check the heart’s electrical activity, looking for irregular heartbeats or signs of heart enlargement. Blood tests can also help rule out other conditions with symptoms similar to valve regurgitation.

For complex cases, doctors may use MRI to get detailed images of the heart’s valves and chambers. However, they typically reserve this test when they need more information to guide treatment.

Treatment for a leaky heart valve during pregnancy depends on its severity and symptoms. Mild cases often require only regular monitoring.

While severe regurgitation may need medications or specialized care. The goal is to manage symptoms while ensuring a safe pregnancy and delivery.

Possible treatment options include:

  • Medications: Doctors may prescribe pregnancy-safe options like beta-blockers, certain diuretics, or vasodilators to manage symptoms such as high blood pressure or fluid buildup.
  • Lifestyle changes: A heart-healthy diet, adequate rest, and limiting salt intake can help reduce strain on the heart. Doctors may also recommend staying hydrated and avoiding strenuous activities.
  • Early delivery: In severe cases, doctors may recommend early delivery to reduce the risk of heart failure and complications during labor and delivery.

A leaky heart valve may affect your delivery plan as doctors aim to reduce heart strain for a safe birth for both you and the baby. In most cases, doctors prefer vaginal delivery since it puts less strain on your heart than a C-section.

They may use assisted delivery (forceps or vacuum extraction) to shorten labor and avoid straining your heart. However, if complications arise, such as heart failure or unstable arrhythmias, a cesarean delivery may be necessary.

During this, doctors will carefully choose anesthesia and pain management to prevent excessive cardiovascular stress during labor.

Most people with mild valve regurgitation can have a healthy pregnancy with proper management. However, the long-term outlook depends on:

  • severity of the condition before pregnancy
  • how well the heart adapts to increased demands
  • response to treatment and monitoring

For severe cases, postpartum follow-up is important, as heart strain may persist after delivery. Some people may require long-term treatment or surgical valve repair later in life.

A leaky heart valve can complicate pregnancy, but with close medical supervision, most people can have a safe pregnancy and delivery.

If you have heart valve disease and are planning a pregnancy, consider talking with a healthcare professional, they can help you develop a proper management plan.