• Aortic Regurgitation

    (Aortic Insufficiency)

    Definition

    Aortic regurgitation is a heart condition in which the valve between the left ventricle (lower left heart chamber) and the aorta (the major blood vessel leaving the heart) is not working properly. This valve defect allows the pumped out blood to leak back into the heart. As a result, the left ventricle must work harder to pump more blood than normal. This increased work gradually causes the left ventricle to enlarge. There are two main types of aortic regurgitation:
    • Acute aortic regurgitation —symptoms develop rapidly, and in severe cases, prompt surgery may be lifesaving
    • Chronic aortic regurgitation —symptoms develop over the course of many months or years
    Aortic Valve Regurgitation
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Possible structural causes of aortic regurgitation:
    • The aortic valve itself is deformed and malfunctions.
    • A heart deformity or disturbance near the valve affects the valve’s functioning.

    Risk Factors

    A risk factor is something that increases your chance for getting a disease or condition.

    Acute Aortic Regurgitation

    Risk factors for developing acute aortic regurgitation include:

    Chronic Aortic Regurgitation

    Risk factors for developing chronic aortic regurgitation include:
    • Bicuspid aortic valve—a congenital (existing at birth) deformity in which the aortic valve has two cusps rather than three
    • Other types of congenital heart disease
    • Infections of the heart such as:
      • Rheumatic fever
      • Infectious endocarditis
      Diseases that cause widening of the aortic root (the part of the aorta attached to the ventricle) such as:
    • Collagen vascular diseases, such as systemic lupus erythematosus
    • Aortic aneurysm
    • Sex: male
    • Age: Over age 50

    Symptoms

    In acute aortic regurgitation, symptoms come on quickly since the heart has not had the time to compensate or enlarge. In chronic aortic regurgitation, symptoms develop more gradually and may not be noticed for years until the condition worsens.
    In both cases, symptoms may include:
    • Shortness of breath
    • Fatigue, especially after physical activity
    • Fluid retention in certain parts of the body, such as the ankles
    • Heart arrhythmias (abnormal heart beats)
    • Angina (chest pain from insufficient blood supply)
    • Hypotension (low blood pressure)

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. In particular, the doctor will use a stethoscope to listen for a murmur (an abnormal heart sound). If you have a certain type of heart murmur, the doctor may suspect that you have aortic regurgitation and may recommend further tests, such as:

    Treatment

    In the case of severe acute aortic regurgitation, especially due to trauma, immediate surgery may be needed.
    For chronic aortic regurgitation, the proper timing of medical therapy versus surgical treatment depends on several factors. These include:
    • When you develop symptoms and how severe they are
    • The degree of heart damage and level of heart function
    • Your age
    • The risks associated with the treatment
    Treatment for aortic regurgitation may include:

    Medications

    If aortic regurgitation is not causing symptoms and heart function remains normal, you may be treated with medications that lower blood pressure. These medications may reduce the pressure against which the heart pumps. Medication may also be given to treat chest pain, to treat irregular heartbeats, to prevent infection of damaged or artificial valves, and to prevent blood clots. If you have heart failure, you may be treated with medications that help your heart pump more effectively.

    Surgery

    Surgery is usually performed for severe acute aortic regurgitation or when the timing is right for chronic aortic regurgitation. If you have chronic aortic regurgitation, your doctor will follow your symptoms and heart function closely in order to determine the best surgical timing for you. Surgery involves replacing the aortic valve.

    Prevention

    Prompt treatment of strep infections can prevent rheumatic fever, which is a risk factor for developing heart valve problems like aortic regurgitation. If you have an abnormal valve, you are at higher risk of developing valve infections. You should talk with your doctor to understand when you may need to take antibiotics to decrease your risk of valve infection. For instance, you may need antibiotics before undergoing certain dental procedures or surgeries.

    RESOURCES

    American Heart Association http://www.heart.org

    National Heart Lung and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca

    Canadian Family Physician http://www.cfp.ca/

    RESOURCES

    Aortic regurgitation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamedUpdated October 10, 2012. Accessed November 7, 2012.

    Cheitlin M. Surgery for chronic aortic regurgitation: when should it be considered? Am Fam Physician . 2001;64(10).

    Tarasoutchi F, et al. Symptoms, left ventricular function, and timing of valve replacement surgery in patients with aortic regurgitation. Am Heart J . 1999;138:477-485.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.