Aortic Insufficiency
(Aortic Regurgitation; Aortic Incompetence)
Definition
The left ventricle of the heart is a muscular chamber. This chamber pumps blood from the heart to the entire body. The blood is pushed through the aortic valve into a major artery, called the aorta. After each heart beat, the valve closes tightly to keep blood flowing away from the heart.
If you have this condition, the valve does not close tightly. Blood leaks from the aorta back into the heart. Most people do not have symptoms and may not need treatment. But, you should talk to your doctor if you think you have this condition. You will need to have tests and get proper treatment.
Aortic Valve Insufficiency
Causes
Aortic insufficiency can be caused by:
- Birth defect in which the aortic valve is bicuspid (two valves), instead of tricuspid (three valves)
- Family history of aortic valve disorder
- Severe high blood pressure
- Bacterial infection of the aortic valve
- Injury to the aortic valve
Risk Factors
These factors increase your chance of developing aortic insufficiency:
- Gender: male
- Family history of aortic insufficiency
Tell your doctor if you have any of these.
Symptoms
These symptoms may be caused by other conditions. Do not assume they are due to aortic insufficiency. Tell your doctor if you have any of these:
- Shortness of breath with activity
- Exercise intolerance
- Dizziness
- Chest pain
- Heart palpitations
- Heart arrhythmia (irregular heartbeat)
- Difficulty breathing when lying flat
Diagnosis
Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Tests may include:
- Chest x-ray —a test that uses radiation to take a picture of the chest
- Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart and assess it’s valves in detail; usually done on the surface of the chest (called a transthoracic echocardiogram)
- Transesophageal echocardiogram (TEE)—a type of echocardiogram that looks at the valve in more detail using an ultrasound probe
- Electrocardiogram (ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle.
- Cardiac catheterization —a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Surgery
If your condition is severe, your aortic valve can be replaced with an artificial valve. In rare cases, the repair can be done without the need for a new valve.
Medications
Your doctor may prescribe medications to manage your symptoms. Examples include:
- Diuretics to treat high blood pressure and rid the body of excess fluids
- Calcium channel blockers to reduce the leaking and, in some cases, delay the need for surgery
- Other medications, such as angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers
- Antibiotics before dental and surgical procedures to prevent infection
Depending on your condition, your doctor may schedule routine physical exams and echocardiograms.
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/
CANADIAN RESOURCES:
Heart Healthy Kit: Public Health Agency of Canada
http://www.phac-aspc.gc.ca/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
References:
Aortic valve stenosis and insufficiency. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=11068 . Accessed September 24, 2008.
Coarctation of aorta. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed November 27, 2006.
Congenital heart defects. Nemours Foundation website. Available at: http://www.kidshealth.org/parent/medical/heart/congenital_heart_defects.html . Updated June 2008. Accessed September 24, 2008.
Scognamiglio R, Rahimtoola SH, Fasoli G, Nistri S, Dalla Volta S. Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function. N Engl J Med. 1994;331:689.
What are congenital heart defects? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/chd/chd_what.html . Updated December 2007. Accessed September 24, 2008.
Last reviewed November 2008 by Michael J. Fucci, DO
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 medical condition.
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