“Will My Husband’s Heart Valve Click?” Asks Jodi

Selecting a mechanical or bioprosthetic heart valve replacement prior to surgery is not easy. There are pros and cons to both types of valve replacement devices. On that note, Jodi just emailed me about one side effect of aortic mechanical valve replacements… The clicking noise.

Jodi writes, “Hi Adam! My husband has aortic valve insufficiency and will need the valve replaced in the near future. We have been seeing his cardiologist every 6 months for 3 years. The cardiologist has recommended that my husband, who is 48 years old, get a mechanical aortic valve. On Friday, when we were in the doctor’s office, we heard for the first time that you can hear the “click” noise of the valve. He has never mentioned that to us before and we are not too excited about that. Can you hear really hear the valve click inside the heart? Does your valve click? –Thanks, Jodi”

This is an interesting question that Jodi raises. So you know, I did not have a mechanical valve implanted during my aortic valve replacement surgery. However, I know several hundred patients that live with mechanical valves.

Patient reactions to the “clicking noise” is mixed. While some patient are annoyed by the click, most get used to the click. Still, there are other patients who don’t hear the clicking noise at all.

For example, here is an interesting patient story about Margaret Reese. Margaret had mechanical valve replacement surgery 27 years ago. In this post, she describes the experience of living with a clicking heart valve.

I hope this helps!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Barbara Watson

    I have to comment on the clicking sound with a mechanical valve. I had a redo of an aortic valve replacement 9/16/08. My 1st valve was a bovine tissue valve replaced in 2001 in Boston. Thanks to Dr. Richard Shemin at UCLA, I had another successful surgery 9 weeks ago. I now have a mechanical valve. No one around me can hear a click. Once in a while when I lie down in bed I can feel my heart beat and sometimes hear a ‘ping’ or maybe just feel the noise. I would not worry about the sound of the valve. I feel great today, just a little soreness left in my chest, and glad to be alive.
    Barbara

  • Susan

    I just turned 50, and it has only been 7 weeks since my double valve replacement (mitral and aortic – St. Jude valves), plus the MAZE procedure. I am feeling terrific! Recovery has been so much easier than I ever expected. I have been truly blessed, even with the minor clicking :-). I do SOMETIMES hear a small clicking noise when it is really quiet, am lying on my back, and resting. It usually doesn’t bother me, but if it does I roll on my right side and it disappears. Noone else in my family can hear it. When I hear the clicking, I also think about what my heart sounded through a stethoscope before the valve replacement. It was a heavy swooshing sound. Although I couldn’t hear it outside my body like the clicking, I know now that my heart is functioning like a real heart. I am grateful to hear that clicking when I think about how it will improve my health in the long run. I’m looking forward to what a full recovery in the coming months will mean to me.

  • Allan

    I just turned 30, and it has been almost 7 weeks since my aortic valve replacement (On-X valve). Both my wife and I can hear the clicking, but we both find it reassuring! Neither of my parents have been able to hear my valve clicking, so I wonder if being able to hear it is not a function of age?

  • fazilat

    regarding the clicking noise of the mechanical valve, i had a mech vave six months ago [aortic] no one around me can hear any clicking noises i can hear it first thing in the morning only when its very quiet.
    good luck with the surgury.
    fazilat

  • Adrian Bishop

    Largely because of my ‘youth’ (61) my cardiologist recommended a mechanical valve, based on its expected longevity. My surgeon, however, recommended strongly that we go tissue. I live on an island with the closest cardiac emergency care 1200 miles away, and I occasionally travel to Africa. My surgeon, Dr Louis Kanda, at the Washington (DC) Hospital Center, is from Congo, and has built a hospital with cardiac care in Kinshasa. He recommended the tissue valve because in his experience they are lasting longer than initially expected, and if they fail he expects them to fail gradually, similar to my failing aortic valve. If a mech valve fails, the patient would require immediate specialized cardiac assistance, not available where I live, nor in most of Africa. Another consideration is that choosing a mech valve obligates you to a life with blood thinners, which the bio-valve does not. I am now off all thinners but aspirin. We chose the bio-valve, recovery so far is excellent 6 months out, and we pray for the best down the road. (We were told about the click, but it was not a factor in our decision making).

  • Vernon Young

    I had a mech valve installed on July 31st of this year. This valve works perfectly. The secret to keeping the valve “quiet” is to make sure that your Coumadin or Warfarin level stays in an INR range of 2.5 to 3.0. If the INR is too high you (not anyone else) will be kept awake at night with it clacking away and you will feel a pulsing sensation along with this throughout your body that will make sleeping a bit more trying. The secret is the INR… keep it within the range that is recommended and you will not even notice that it is there.

  • Adam Pick

    Barbara, Allen, Adrian, Vernon, Fazilat & Susan –

    Thanks for the great responses, comments, thoughts and strategies for dealing with the clicking noises of mechanical valve replacements. I know this will help Jodi and other patients / caregivers in the future!

    Keep on tickin!

    Adam

  • Michael Lupo

    My name is Mike and I had my valve replaced by Dr Alan D Hilgenberg at Massachusetts General Hospital in Boston.
    I had a Bovine Pericadial valve implanted in the aortic position on Feb 3rd 2006. I was 41 at the time. I was also the recipient of a shiny brand new dacron graft replacing the first 3 inches of my ascending aorta. The arch was not involved (thankfully). I do not have marfans. Like many of those who have already posted here, I had a decision to make. Fully mechanical and a life of coumadin and the lifestyle that comes with being coumadin dependent OR a bio-prosthetic and a daily regimen of asprin…and have the valve re-replaced after x years.
    My decision to go with the bio prosthetic was based on the fact that I did not want to live having my blood drawn each month to monitor my blood “thinness”. Also, I am an avid off piste skiier and if I were to encounter an injury like a femur fracture on the mountain, i might bleed to death internally. So my lifestyle also played a part in my decision.

    My cardiologist decided recently to put me on Crestor (a statin) to lower my cholesterol. My cholesterol was already in the normal range but studies have suggested that a lower cholesterol will lengthen the life of a bioprosthetic valve. Something to the tune of 20 years. I am hopeful but unfortunately, the outcome of this study will rely on the statistics set by mine and other’s prostethic valve failure. Keeping my fingers crossed and my hopes up…

    If anyone has any questions, please feel free to contact me. My email is mikelupo AT aol dot com. I’m more than glad to assist in any way that I can.

  • Marty

    I had mine replaced in 1980 a Bjory Shiley and have lived with the ticking you get used to it and it’s not like it’s even there.

  • Dan Miller

    Just a quick word about mechanical valves that can save a life. I received a mechanical valve in 1989 at the age of 16. In 2007, I had endocarditise and had to have aortic (and pulmonary) valve replacement. Before the June 2007 surgery they wanted to do an MRI. I had the doctor check to make sure my mechanical valve would be able to go through an MRI. IT WOULD NOT!!! To this day, I imagine what could have happened, if I had not asked. If you have a mechanical aortic valve, have your doctor check and make sure it can go through an MRI.

  • George S

    Not to worry about having an MRI with a mechanical heart valve. If the doctor should ever inadvertently prescribe one, the MRI facility will have you complete a long questionnaire, which always asks about implants and metal. They will not let you undergo an MRI. Most times the MRI Tech will ALSO ask about implants after the questionnaire and before the procedure. They have this covered.

  • Jeremi E

    I had my second valve replacement surgery in December at the University of Michigan hospital. I am 30 years old and had the Ross procedure done when I was 17. I now have a mechanical valve and it is pretty loud. Being that I am all ready an anxious person I have a real hard time falling asleep at night. I have a check-up in a few weeks so I’ll tell my doctor about it and see if they can raise my INR which is only around a 2 right now. Hopefully I get used to it.

  • Eliane Jean-Philippe

    I had a mechanical valve replacement in august 27, 2009 and currently taking warfarin a type of (caumodin) when i left the hospital i was on 5 mg now i am taking 12 mg because my blood level is 1.6. and I too can hear the clicking day and night and so does my family and friends. any movement I make such as go up the stairs you can hear it clicking like a time bomb ready to explode that’s how loud it is. and lately i get short of breath, my chest itch, and sore at the same time. And if I’m having a confrontation with someone I get short of breath and lifgt headed I feel tired.

  • Midge

    Just had a mechanical valve implanted 2/13/09 and could not be happier with the choice. I have NO clicking noise and only “feel” my heartbeat in various parts of my body when I lay down to sleep. For only 2 weeks out, I feel very good…walking 30 min. a day and doing the breathing exercises help. Coumadin is a new adventure in my life but it is running pretty stable these first two weeks around 2.65-2.9. Since I am on Medicare and they approve the in-home testing machine, will hopefully got for that in the future. I am a 67 yr old female who owns a manufacturing company and in my normal life get plenty of walking and lifting exercise so that may have made this surgery easier. But I chose the mechanical valve so that I would not have to do this again in my lifetime and after the surgery, it only confirmed that I made the right decision.
    Midge

  • jeff stoveken

    i had a st judes aortic valve installed in 9/08 and i hear clicking as well. its actually comforting to me to know its working .i used to hear thumping also but that went away for the mostpart. it took me 3 months to get level on coumadin.diet and activity kept changing it.has anyone been able to see the heartbeat in their eyes? jeffstoveken@yahoo.com for any advice or questions, thanks,jeff

  • Kashina Newsome

    Hi,My name is Kashina Newsome and I had a mitral valve replaced own october 21, 2009 and I got a mechanical valve and the clicking noise is very loud and annoying.I feel down sometime when my kids say momma that is a very loud noise we here. I wish I didn’t have to here the sound but I can say i’m blessed to be here with my 3 kids my blood pressure dropped so they had to get in a hurry and sew me up so I say again i’m blessed.I just wish it was something they could do about the clicking sound and by the way I am 31 years of age. Hope to here from you guys soon.

  • Peter G.

    Thank you all for your comments and evaluations. Heading into surgery on Tuesday and still am undecided on the type of valve. I would like to talk to my surgeon again before I make a decision. I guess all of us repond differently and perhaps the valves even function differently in each person. I am glad all are doing well. Continued health.

    Peter G.

  • Paul K

    Had mitral and aortic valves replaced in Dec 2011,,,mechanicals. The clicking is definitely annoying..not only can I hear, but family also hears. Even medical personnel (techs, nurses, etc) comment on it. Sometimes makes sleeping difficult. It’s only been 6 months so am hoping to get used to it so it becomes a non-issue.

  • Leila

    I had a mechanical mitral valve replacement in January 2003 (@ 27 yrs), I can tell you that you do get use to the clicking sound. Mine clicks whether my INR is at 2.5 or 3.5, so I don’t think that the INR level makes a difference…it is suppose to click. At least I know it’s working, and that is reassuring. = )

  • Faye

    My dad has a metal heart valve and has since I was about 3 years old, but I use to like laying on his chest and listening to the tick, he used to tell me it was like a clock. I don’t remember ever hearing my dads heart beat but always the tick. It was interesting though and my dad liked showing it to me and my sister. It’s not that bad, it’s quite nice actually.

  • John Acosta

    I had an OmniScience Aortic valve implanted in September of 1983 (@ age 24). Nearly 30 years after, I can honestly say that it was louder than I anticipated. On thing that helped me get use to the clicking sound was to begin wearing a watch that ticked and sleep with a Big Ben wind up clock near my bed. After six months of getting used to the “external” ticking sources, I was able to deal with my heart valve clicking. Coumadin levels have stayed rock solid for almost 30 year… I’ve been truely blessed.

  • Christine

    My hsuband has a mechanical aortic valve that he recieved almost 3 years ago. The clicking is driving him crazy! He is in rehab right now because he has been using drugs to silence it.

    He needs to be treated for PTSD. They never told us about the clicking before he had surgery or that he might get depressed or anything of the sort.

    They are more than happy to have you do physical therapy, but what about the mental part?

  • Lynn

    I had an experimental Omniscience aortic valve implanted in 1983 at the age of 24 that was never FDA approved because of issues that arose for the majority of patients who had them implanted. I’m happy to report I am now 55 years old and have had absolutely zero problems in the nearly 31 years of service, except for the fact that it produces an unbelievably loud clicking (not only can I hear it constantly but people within 3 to 5 feet can also hear it). After my surgery I was given some advice by my surgeon (Dr. Denton Cooley) that I would like to pass on to your husband. He recommended me to start wearing the loudest watch I could find and sleep with a Big Ben wind up clock next to my bed (wasn’t married at the time). After about a year of doing this, I started becoming less aware of my heart valve clicking and have grown to associate it as a re-assurance. Good luck to your husband overcoming his anxiety with the valve clicking.

  • Tom

    Hi,
    I had my aortic valve replaced in 2003 with a mechanical valve and I’ve been living with the clicking sound ever since and it never really troubled me.
    Recently though I have become a little anxious about it as I have noticed a change in the noise it makes.
    It still clicks but there is now a very high-pitch squeaking noise with every heartbeat.
    I’m worried that this could be something going wrong with the valve.
    Does anybody know what could be causing it to squeak like this? It’s so high pitched that it’s actually giving me headaches hearing it.
    P.S. Just as a side note I was struggling with alcohol issues for quite some time during 2012-2013. I am taking warfarin. Could the squeaking be a clot on the valve?
    Cheers!

  • Kevin

    Hello All:

    Great thread here. Just thought I would throw my .02 in here.

    I had a Ross Procedure in 1996 (Double Valve Transplant that puts your Pulmonary Valve in the Aortic position and brings in a new Pulmonary Valve). It is a tricky operation as it is like splitting Aces, you need to win 2 hands instead of just winning one. So in 2004 I had a modified David Procedure (repairs the Aortic Valve with Dacron Material and secures the Root). So last October in 2012 I had a St. Jude Valve installed and dacron tubing installed at the root. Needless to say it went very well, I feel like a new person and can do more than I could before. I do hear the clicking very loud though, (I call it the symphony of life). My INR is in range but I do hear the clicking. In a social setting you cannot hear it at all, but at work, church, on the tee box golfing I hear it in stereo. Hey, you learn to love it. I certianly beats the alternative and it keeps me on the right side of each divot. Hope this helps. Keep Clicking!

  • Scott

    Had the aortic valve(St Jude Mechanical) and part of the stem replaced, and a single bypass (80%) on 11/18/2013.
    Very loud, I can hear it, and feel it both in my chest and in my ears. But today is only 3 weeks post op. Hopefully it will get better… I also have a-fib so its not even a steady beat.
    I use a fan 365 days a year, so hopefully once I can sleep flat again it will drown out most of it..in a recliner now.
    Whatever happens… I NEVER EVER want to go through this again..it was a bad first 10 days, I was in the hosp 12 days..

  • Kevin

    Hey Scott:

    I hope your recovery is getting better. I will keep you in my thoughts and prayers. I am a year out of my St. Jude Valve / Stem Replacement and I have never felt better. I have very loud clicking and can feel it but I get up at 4:30 every morning and run 3 miles and lift light weights every weekday. As for the a-fib you may want to look into that but it could be junctional tachycardia, just a faster heart rate at times, it can work itself out. I was drinking too much caffeine and I monitor that and I do not get it much. Try to take deep breaths and stay calm but know that their are others out there like you. Stay positive and try to get a routine down and it will work out. You will get used to the clicking, the only time you have a problem is when you do not hear the click. It is really loud to you but most people cannot hear it so just embrace it.

    Keep Clicking.)

    Kev

  • Kevin

    P.S. the Coumadin may keep you cooler so the fan might not be necessary anymore. Might replace it with a space heater or a radio.)

    Keep clicking my friend…

    Kev

  • Ali

    Hi, i had my double valve (aortic and mitral) replacement almost 2 years ago at the age of 30. (Sorin)

    It was quite disturbing to hear clicking sounds for the first 6 months but than i started to not to hear it. If i am not in a silent car or elevator etc. i dont hear it.

    And people around me sometimes hears it but they know ithat i have clicking valves. if somebody doesnt know it, they dont hear it.

    So, dont be panic, you will start to love this clicking sound and every time you have experiences with the people around you, you will be happy to have it.

  • Christine

    My husband had aortic valve stenosis and they replaced the aortic valve with a mechanical valve. He could not stand the clicking and did not sleep the entire time following his surgery. That was 3 1/2 years ago. HIs doctors paid no attention. They said “give it time” or “you are fine”. He ended up taking his own life.

  • Nick

    I am so sorry to hear that Christine. Why was he not given the option of a reop with a tissue valve. I have had an on-x valve put in a little over a month ago. I knew within 2 days I had made a massive mistake as the sound is driving me down the same dark road. I have asked for a reop with a tissue valve and have been told I can have it but will have to wait a few months for the body to heal before reoperating. I have been told I do not have to live with this clicking. I still find it hard having to wait though.

    Why is more not made about the sound of these valves, if you cannot stand noise you will not be able to cope with a valve sound. It will reduce your quality of life. I was encouraged to go mechanical by the surgeon and I regret that choice, but at the time I thought it was the right thing to do, but we should all still have options available.

  • Jay

    I’ve had 4 Ross Procedures in 9 years that failed due to tissue failure or twisting. Then had a mechanical valve fitted in Sept 2008. This thing has driven me crazy since I woke up after it was fitted. I’d prefer to be dead than have this sound, it’s really loud. People comment all the time – ‘can you hear that dripping tap?’, or ‘what’s that noise, can you hear it?’. I stopped taking my Coumadin, or Rat Poison – look up the history of Warfarin for yourself, in the hope my heart will eventually just clog or shut down. I’m not depressed and have a love and zest for life, but the Mechanical Valve destroyed the desire to continue. I’m not dumb enough to do something stupid and have spent many fruitless hours searching the web for ways to quieten it down. I repeat – I’m not depressed!! Just sick of not only hearing it but feeling it too at every moment of the day, I never get any peace from it. From Melbourne Australia with a globally respected professor as my surgeon.

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