Heart valve disorders
Aortic valve regurgitation
What is aortic valve regurgitation?
Your aortic valve lies between your aorta and your left ventricle. It opens when your ventricle contracts so that re-oxygenated blood can flow into your aorta and out to the rest of your body.
For more information about how your heart works, take a look at Your heart: The basics.
Aortic valve regurgitation
When your ventricle relaxes again and refills with blood from your lungs, the leaflets on your aortic valve close, and this prevents the re-oxygenated blood in your aorta from flowing back into your ventricle again.
If you have aortic valve regurgitation (also commonly known as aortic regurgitation or aortic insufficiency) that means your aortic valve is leaking and some of the blood that your left ventricle pumps out into your aorta when it contracts is being sucked back into your ventricle again as it relaxes and expands.
Aortic valve regurgitation prevents your heart from pumping efficiently and it forces your heart muscle to work much harder than it should.
You may be born with a valve problem that predisposes you to developing aortic valve regurgitation, or you may develop it as a result of infection, trauma, or some kind of cardiovascular disease.
If your condition is severe, you may need to have surgery to repair or replace your aortic valve.
What causes aortic valve regurgitation?
The most common genetic cause of aortic valve regurgitation is a bicuspid aortic valve. (If you have a bicuspid valve that means your aortic valve has two leaflets, or cusps, instead of the normal three.)
About 1% of people are born with bicuspid aortic valves and a small proportion of those people will go on to develop valve problems later in life.
The most common acquired, or non-genetic, cause is valve degeneration and stenosis as a result of normal aging. The older we get, the more likely we are to develop heart valve problems.
Prior to the development of effective antibiotics, rheumatic heart disease, which is an inflammatory condition resulting from untreated strep throat, was one of the most frequent causes of aortic valve regurgitation. Inflammation of the heart can damage the valves and is very dangerous. Rheumatic heart disease is now rare in the developed world, but it can still be a problem in developing nations.
Some risk factors for aortic valve regurgitation take years, or decades, to cause problems. People with bicuspid valves might develop regurgitation in their 50s, those with rheumatic valve damage in their 30s, and those with stenosis in their 60s or older.
In addition to the long-term causes of aortic valve regurgitation, there are a few disorders that can cause it quite suddenly, or acutely, like endocarditis or an aortic dissection.
Common long-term causes of aortic valve regurgitation include:
- Aortic valve stenosis: Stiffening and thickening of the aortic valve’s leaflets. This can happen with normal aging
- A bicuspid aortic valve: This is a relatively common congenital heart problem that increases your risk of developing aortic valve problems later in life
- Rheumatic valve disease
- Tertiary syphilis
- Aortic aneurysm
Acute, or sudden, causes of aortic valve regurgitation include:
- Endocarditis: An infection of the heart’s chambers and valves
- Injury or trauma
- Aortic dissection
What are the symptoms of aortic regurgitation?
If you have mild aortic regurgitation you may not really notice it, but if your condition worsens with time, or if you develop the condition quite suddenly, you may experience quite severe symptoms.
Here are some common symptoms of aortic regurgitation. If you experience these symptoms you should immediately seek medical advice:
- Shortness of breath when you exercise or lie down
- Palpitations and a fast, fluttering heartbeat
- Chest discomfort or pain
Aortic regurgitation may lead to left heart failure, and if that happens your symptoms may also include tiredness and swollen feet and ankles.
How is aortic valve regurgitation treated?
Your doctor will determine the best course of treatment for your aortic valve regurgitation based on the severity of your symptoms.
If you have mild regurgitation you may not need any treatment at all.
However, if you doctor is concerned and wants to make sure you condition doesn’t worsen, he or she may recommend one or more of the following treatments:
- Medications to help dilate your blood vessels and decrease the burden on your left ventricle
- Diuretics to reduce your fluid load
- Lifestyle changes to help get high blood pressure under control
- Surgery: In severe cases, you may need surgery to repair or replace your aortic valve
What are the aims of treatment?
The aims of treatment for people with mild aortic valve regurgitation are to stabilize your condition and prevent it from worsening. If your condition is more severe, and you need surgery, the aim is to restore normal valve function.