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why do people with a leaky valve find it difficult to exercise

I wrote that less blood can go to the heart so less oxygen goes to the heart, less respiration for contraction so heart can't pump a lot of blood to body cells which require energy for repisration
Reply 1
You could say any of these points:

backflow can occur or some blood flows backwards

less blood leaves the heart or less blood is pumped around the body or some blood stays in the heart (instead of being pumped out) or reduced blood pressure or reduced flow rate

less oxygen supplied to muscles / cells

(so) less aerobic respiration

(so) less energy released

(so) less (efficient) muscle contraction

anaerobic respiration takes place

less (efficient) removal of lactic acid or lactic acid builds up or oxygen debt occurs

(lactic acid building up) causes muscle fatigue

less (efficient) removal of carbon dioxide (from blood)

you HAVE to refer to respiration and the effect this has on excercise and form these points into a logical and clear account.

Ik im a bit late so it doesnt help now but could help anyone else