Aortic Regurgitation Overview
Learn About Aortic Regurgitation
Aortic regurgitation is a heart valve disease in which the aortic valve does not close tightly. This allows blood to flow from the aorta (the largest blood vessel) into the left ventricle (a chamber of the heart).
Aortic valve prolapse; Aortic insufficiency; Heart valve - aortic regurgitation; Valvular disease - aortic regurgitation; AI - aortic insufficiency
Any condition that prevents the aortic valve from closing completely can cause this problem. When the valve does not close all the way, some blood comes back each time the heart beats.
When a large amount of blood comes back, the heart must work harder to force out enough blood to meet the body's needs. The left lower chamber (left ventricle) of the heart widens (dilates) and the heart beats very strongly (bounding pulse). Over time, the heart becomes less able to supply enough blood to the body.
In the past, rheumatic fever was the main cause of aortic regurgitation. The use of antibiotics to treat strep infections has made rheumatic fever less common. Therefore, aortic regurgitation is more commonly due to other causes. These include:
- Ankylosing spondylitis
- Aortic dissection
- Congenital (present at birth) valve problems, such as bicuspid valve
- Endocarditis (infection of the heart valves)
- High blood pressure
- Marfan syndrome
- Reiter syndrome (also known as reactive arthritis)
- Syphilis
- Systemic lupus erythematosus
- Trauma to the chest
Aortic insufficiency is most common in men between the ages of 30 and 60.
The condition often has no symptoms for many years. Symptoms may come on slowly or suddenly. They may include:
- Bounding pulse
- Chest pain similar to angina (rare)
- Fainting
- Fatigue
- Palpitations (sensation of the heart beating)
- Shortness of breath with activity or when lying down
- Waking up short of breath after falling asleep
- Swelling of the feet, legs, or abdomen
- Uneven, rapid, racing, pounding, or fluttering pulse
- Weakness that is more likely to occur with activity
You may not need treatment if you have no symptoms or only mild symptoms. However, you will need to see a health care provider for regular exams and echocardiograms.
Diuretics (water pills) or other types of medicines may be prescribed for symptoms of heart failure.
In the past, most people with heart valve problems were given antibiotics before dental work or an invasive procedure, such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart. However, antibiotics are now used much less often.
You may need to limit activity that requires more work from your heart. Talk to your provider.
Surgery to repair or replace the aortic valve corrects aortic regurgitation. The decision to have aortic valve replacement depends on your symptoms and the condition and function of your heart. There is increasing interest in a minimally invasive procedure in which a replacement valve is implanted via catheter. This is similar to a procedure traditionally done in people with aortic stenosis. This option may become more common in the future.
You may also need surgery to repair the aorta if it is enlarged.
Sanford Bismarck
Colby Halsey is a Cardiac Electrophysiologist and a Cardiologist in Bismarck, North Dakota. Dr. Halsey and is rated as an Experienced provider by MediFind in the treatment of Aortic Regurgitation. His top areas of expertise are Atrioventricular Nodal Reentrant Tachycardia (AVNRT), Arrhythmias, Atrial Fibrillation, Pacemaker Implantation, and Cardiac Ablation. Dr. Halsey is currently accepting new patients.
Sanford Bismarck
Diane Kraft is a Cardiologist in Bismarck, North Dakota. Dr. Kraft and is rated as a Distinguished provider by MediFind in the treatment of Aortic Regurgitation. Her top areas of expertise are Aortic Regurgitation, Heart Failure with Preserved Ejection Fraction (HFpEF), Arrhythmias, and Sick Sinus Syndrome. Dr. Kraft is currently accepting new patients.
Sanford Bismarck
Nayan Desai is an Interventional Cardiologist and a Cardiologist in Bismarck, North Dakota. Dr. Desai and is rated as an Advanced provider by MediFind in the treatment of Aortic Regurgitation. His top areas of expertise are Necrosis, Angina, Heart Failure with Preserved Ejection Fraction (HFpEF), Aortic Valve Replacement, and Transcatheter Aortic Valve Replacement (TAVR). Dr. Desai is currently accepting new patients.
Surgery can cure aortic insufficiency and relieve symptoms, unless you develop heart failure or other complications. People with angina or congestive heart failure due to aortic regurgitation do poorly without treatment.
Complications may include:
- Abnormal heart rhythms
- Heart failure
- Infection in the heart
Contact your provider if:
- You have symptoms of aortic regurgitation.
- You have aortic insufficiency and your symptoms worsen or new symptoms develop (especially chest pain, difficulty breathing, or swelling).
Blood pressure control is very important if you are at risk for aortic regurgitation.
Summary: The VANGUARD study is an open-label, prospective, randomized trial comparing the long-term outcomes of two advanced bioprosthetic aortic valves, Dafodil® and INSPIRIS Resilia®, in patients undergoing aortic valve replacement (AVR). This study aims to provide robust data on valve durability, safety, and hemodynamic performance, particularly in younger patients who may require multiple interventions...
Summary: The purpose of the study is to compare the various 2D and 3D methods of valvular heart disease quantification (Doppler, PISA, VCA, volumetric method) and strain with cardiac magnetic resonance (CMR) measurements of left and right ventricular systolic function strain and myocardial fibrosis assessment.
Published Date: February 27, 2024
Published By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bonow RO, Nishimura RA. Aortic Regurgitation. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 73.
Carabello BA, Kodali S. Valvular heart disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 60.
Leon MB, Mack MJ. Transcatheter Aortic Valve Replacement. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 74.
Writing Committee Members, Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg. 2021;162(2):e183-e353. PMID: 33972115 pubmed.ncbi.nlm.nih.gov/33972115/.