I’ll talk about the most common valvular disorders with respect to heart failure, those of which are

• Mitral valve (stenosis and incompetence)
• Aortic valve (stenosis and incompetence)

P.S. all the above disorders cause total heart failure (Lt. & Rt.-sided) except Mitral stenosis which causes right-sided heart failure only. Here we go…

Mitral stenosis

• caused mainly by: rheumatic valvulitis, or senile calcification
• causes accumulation of blood in the left atrium –> hypertrophy and dilatation –> pulmonary venous congestion –> pressure extends to the pulmonary arterial system –> pulmonary arterial hypertension –> right-sided heart failure

Aortic stenosis

• caused mainly by: rheumatic valvulitis, or senile calcification
• causes accumulation of blood in the left ventricle –> hypertrophy, dilatation, insufficiency –> left-sided heart failure
• consequently, accumulation of blood in the left atria (because the lt. ventricle is full) –> hypertrophy and dilatation –> pulmonary venous congestion –> pressure extends to the pulmonary arterial system –> pulmonary arterial hypertension –> right-sided heart failure (late)
• Angina Pectoris during either systole or diastole as the coronary filling is insufficient in both cases (see Angina Pectoris due to Aortic incompetence)

Mitral incompetence

• caused mainly by: rheumatic valvulitis, or functionally by force-stretching due to acc. high blood pressure in the left ventricle in left-sided heart failure (see fig. below)
• causes regurgitation of blood from Lt. ventr. to Lt. atrium during systole, and accumulation of blood in both of them during diastole –> Lt. ventricular insufficiency and pulmonary venous congestion –> Left and right sided heart failure

Aortic incompetence

• caused mainly by: rheumatic valvulitis, or functionally by force-stretching due to acc. high blood pressure in the left ventricle in left-sided heart failure (see fig. below)
• causes regurgitation of blood into Lt. ventr. during diastole (low diastolic pressure), and over-emission of blood during systole (high systolic pressure) –> Waterhammer’s pulse
• Regurgitation also causes accumulation of blood in Lt. ventricle, then Lt. atrium –> Lt. ventricular insufficiency and pulmonary venous congestion –> Left and right sided heart failure
• Angina Pectoris during diastole only (theoritically) as the coronary filling is insufficient in that case (see Angina Pectoris due to Aortic stenosis)