6th May 2025

Primary and secondary valve disease

As a general rule, valve disease can be considered as primary or secondary.

Primary valve disease refers to abnormalities of the valve or valvular apparatus, while secondary valve disease refers to abnormalities of the annulus or chamber in which it sits. For example, infective endocarditis causing a perforation in a mitral valve leaflet would cause primary mitral regurgitation (MR), while dilation of the left ventricle in the context of heart failure would cause mitral annular dilation and secondary MR due to failure of leaflet coaptation. This is important, as the treatment for the same downstream effect will ultimately depend upon the upstream cause.