Heart valve disease: hemodynamic during physical exertion

During exercise, large amounts of venous blood are returned to the heart from the peripheral circulation.

As a result, all the motivational abnormalities that occur in the different types of heart valve disease are much more severe. Even in people with mild heart valve disease, where symptoms can be difficult to notice at rest, severe symptoms often develop with heavy exercise. For example, in patients with damage to the aortic valve, exertion can cause acute left ventricular failure followed by acute pulmonary oedema. Also, in patients with mitral valve disease, exercise can cause so much blood in the lungs that severe or even fatal pulmonary oedema can occur after as little as 10 minutes.

Even in mild to moderate valvular heart disease, the patient's cardiac reserve decreases proportionally with the severity of valve dysfunction. That is, the cardiac output does not increase as much as during exercise. As a result, the body's muscles get tired quickly due to too little blood flow to the muscles.