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) malfunctions. 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
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
The doctor will ask about your symptoms and medical history, and perform a physical exam. 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:
(EKG, ECG)—a test that records the heart's electrical activity using electrodes attached to the surface of the chest. In severe aortic regurgitation, the EKG may show abnormal electrical activity.
—an x-ray to determine the approximate size and shape of the heart. In aortic regurgitation, the chest x-ray may show enlargement of the lower left ventricle, or in some cases, enlargement of the aorta.
—a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart. It can detect leaking of the valves and abnormal thickening of the heart muscle. This test can also examine the functioning of the left ventricle.
—a tube inserted into the heart through an artery (usually in the groin) to detect problems with the heart's structure, function, and blood supply
(nuclear scan)—measures how well the left ventricle is pumping as well as the amount of blood being pumped out of the ventricle with each heartbeat
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
The risks associated with the treatment
Treatment for aortic regurgitation may include:
If aortic regurgitation is not causing symptoms and heart function remains normal, you may be treated with medications that lower blood pressure to 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 to pump more effectively.
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.
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 in what circumstances 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.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a