Damage to the AV valves or chordae tendineae can lead to what condition?

• A. Forward flow to the lungs
• B. Regurgitation into the atria during ventricular contraction
• C. Increased heart rate
• D. Valve stenosis only

Answer: (B)

Damage to the AV valves or chordae tendineae causes valvular incompetence, meaning the valve leaflets don’t seal properly during contraction of the ventricle. When the ventricle contracts (ventricular systole), blood should move forward into the great arteries, and the AV valves should close to prevent backflow into the atria. If the chordae or valves are damaged, they can prop open or fail to coapt fully, so blood leaks backward into the atria. This regurgitation during systole is why the condition described is regurgitation into the atria during ventricular contraction.

Because some blood is leaking back rather than moving forward, forward flow to the lungs is reduced, and there can be volume overload of the atria (and, on the left side, potential pulmonary congestion). Valve stenosis, by contrast, involves a narrowed valve opening and obstructs forward flow, not backflow, so it’s a different problem. Increased heart rate is not a direct consequence of valve incompetence, and the issue here is specifically regurgitation due to valve damage.