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Condition

Aortic Regurgitation

Symptoms, Doctors, Treatments, Research & More

Condition 101

What is the definition of 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).

What are the alternative names for Aortic Regurgitation?

Aortic valve prolapse; Aortic insufficiency; Heart valve - aortic regurgitation; Valvular disease - aortic regurgitation; AI - aortic insufficiency

What are the causes for Aortic Regurgitation?

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 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.

What are the symptoms for Aortic Regurgitation?

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 some time 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

What are the current treatments for Aortic Regurgitation?

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 echocardiograms.

If your blood pressure is high, you may need to take blood pressure medicines to help slow the worsening of aortic regurgitation.

Diuretics (water pills) 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.

You may also need surgery to repair the aorta if it is enlarged.

What is the outlook (prognosis) for Aortic Regurgitation?

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.

What are the possible complications for Aortic Regurgitation?

Complications may include:

  • Abnormal heart rhythms
  • Heart failure
  • Infection in the heart

When should I contact a medical professional for Aortic Regurgitation?

Call 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).

How do I prevent Aortic Regurgitation?

Blood pressure control is very important if you are at risk for aortic regurgitation.

REFERENCES

Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 66.

Lindman BR, Bonow RO, Otto CM. Aortic valve disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 68.

Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(25):e1159-e1195. PMID: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.

Otto CM. Valvular regurgitation. In: Otto CM, ed. Textbook of Clinical Echocardiography. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 12.

Latest Research

Latest Advance
Study
  • Condition: Pediatric Cardiology
  • Journal: Pediatric cardiology
  • Treatment Used: Various Treatments
  • Number of Patients: 0
  • Published —
This article provides a summary and description of recent articles and topics in pediatric cardiology and treatments.
Latest Advance
Study
  • Condition: Adult Structural Heart Disease (SHD)
  • Journal: Vascular and endovascular surgery
  • Treatment Used: Transcatheter Treatment
  • Number of Patients: 33
  • Published —
This study described first-year experience after initiating a structural heart diseases (SHD) program treating severe aortic stenosis, aortic regurgitation, mitral valve prolapse and regurgitation, as well as paravalvular leaks.
Latest Advance
Study
  • Condition: Severe Bicuspid Aortic Valve Stenosis
  • Journal: American heart journal
  • Treatment Used: Transcatheter Aortic Valve Replacement
  • Number of Patients: 567
  • Published —
The purpose of the study was to evaluate the outcomes of transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis.
Latest Advance
Study
  • Condition: Patients with Severe Aortic Stenosis and Low Surgical Risk
  • Journal: Circulation
  • Treatment Used: Transcatheter vs. Surgical Aortic Valve Replacement (SAVR)
  • Number of Patients: 1000
  • Published —
This study compared low-risk patients with severe aortic stenosis (occlusion) after surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR).

Clinical Trials

Clinical Trial
Diagnostic Test
  • Status: Recruiting
  • Study Type: Diagnostic Test
  • Participants: 40
  • Start Date: February 18, 2020
Short-term and Midterm Results of the Aortic Valve Reconstruction With Autopericardium in Children
Clinical Trial
Other
  • Status: Recruiting
  • Participants: 2130
  • Start Date: December 12, 2019
A 10-Minute Cardiovascular Magnetic Resonance Protocol for Cardiac Disease