Heart valve

A heart valve normally allows blood to flow in only one direction through the heart. The four valves commonly represented in a mammalian heart determine the pathway of blood flow through the heart. A heart valve opens or closes incumbent on differential blood pressure on each side.

The four main valves in the heart are:

The mitral valve and the aortic valve are in the left heart; the tricuspid valve and the pulmonary valve are in the right heart.

There are also the coronary sinus and the inferior vena cava valves.

Structure

The heart valves and the chambers are lined with endocardium. Heart valves separate the atria from the ventricles, or the ventricles from a blood vessel. Heart valves are situated around the fibrous rings of the cardiac skeleton. The valves incorporate leaflets or cusps, which are pushed open to allow blood flow and which then close together to seal and prevent backflow. The mitral valve has two cusps, whereas the others have three. There are nodules at the tips of the cusps that make the seal tighter.

Aortic valve

The aortic valve is one of the two semilunar valves of the heart, the other being the pulmonary valve. The heart has four valves and the other two are the mitral and the tricuspid valves. The aortic valve normally has three cusps or leaflets, although in 1–2% of the population it is found to congenitally have two leaflets. It lies between the left ventricle and the aorta.

Structure

The aortic valve normally has three cusps – a left, right and posterior cusp.

Function

During ventricular systole, pressure rises in the left ventricle. When the pressure in the left ventricle rises above the pressure in the aorta, the aortic valve opens, allowing blood to exit the left ventricle into the aorta. When ventricular systole ends, pressure in the left ventricle rapidly drops. When the pressure in the left ventricle decreases, the aortic pressure forces the aortic valve to close. The closure of the aortic valve contributes the A₂ component of the second heart sound (S₂).

Clinical significance

Mitral valve

The mitral valve (also known as the bicuspid valve or left atrioventricular valve) is a dual-flap (bi- from the Latin, meaning "double", and cusp, meaning "point"; mitral from the Latin, meaning "shaped like a mitre") valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). The mitral valve (not to be confused with the congenital bicuspid aortic valve) and the tricuspid valve are known collectively as the atrioventricular valves because they lie between the atria and the ventricles of the heart and control the flow of blood.

During diastole, a normally-functioning mitral valve opens as a result of increased pressure from the left atrium as it fills with blood (preloading). As atrial pressure increases above that of the left ventricle, the mitral valve opens. Opening facilitates the passive flow of blood into the left ventricle. Diastole ends with atrial contraction, which ejects the final 20% of blood that is transferred from the left atrium to the left ventricle. This amount of blood is known as end-diastolic volume (EDV), and the mitral valve closes at the end of atrial contraction to prevent a reversal of blood flow.