What is aortic valve regurgitation?
Aortic valve regurgitation is a problem with the aortic valve. The aortic valve allows blood to flow from the heart's lower left chamber (ventricle) into the aorta and to the body. When the heart rests between beats, the valve closes to keep blood from flowing backward into the heart.
When you have aortic valve regurgitation, the aortic valve doesn't close as it should. With each heartbeat, some of the blood leaks back (regurgitates) through the aortic valve into the left ventricle. The body does not get enough blood, so the heart has to work harder to make up for it. See a picture of aortic valve regurgitation .
You can have this problem for a long time and not know it. It may take years for symptoms to start. This is called chronic aortic valve regurgitation. In rare cases, the valve problem starts suddenly and without warning. This is called acute aortic valve regurgitation. It requires medical help right away.
What causes aortic valve regurgitation?
Any condition that damages the aortic valve can cause aortic valve regurgitation. Common causes of chronic valve problems include:
- Being born with a bicuspid aortic valve or a damaged aortic valve.
- Enlargement of the aorta because of high blood pressure or hardening of the arteries.
- Rheumatic fever.
The most common causes of sudden (acute) aortic valve regurgitation include:
- Endocarditis, which is an infection in the heart.
- Aortic dissection, which means that the inner layer of the aorta separates from the middle layer.
- Problems with a replacement (artificial) aortic valve.
- Trauma to the heart valve or aorta.
What are the symptoms?
For chronic regurgitation, you may not have any symptoms at first. But over time you may have:
- Fatigue or weakness.
- Shortness of breath, most often when you are active.
- A fast, slow, or uneven heartbeat (arrhythmia).
- A feeling that your heart is pounding, racing, or beating unevenly (palpitations).
- Chest pain or pressure (angina), often brought on by exercise, when the heart has to work harder.
If you start to notice any of these symptoms, let your doctor know right away.
When the valve problem is acute, these symptoms are sudden, often more intense, and life-threatening.
How is aortic valve regurgitation diagnosed?
Your doctor may suspect that you have this type of valve problem after hearing a heart murmur through a stethoscope. He or she will ask about your symptoms and past health and will want to know if you have any family history of heart disease.
You will get further tests, like an echocardiogram to confirm the diagnosis, to show how much the valve is leaking, and to see how well the left ventricle is working.
How is it treated?
Your treatment will depend on what is causing your valve problem and if you have symptoms.
If your aortic valve regurgitation starts suddenly and is acute, you'll need valve replacement surgery right away.
But in most people, aortic valve regurgitation starts slowly. Your doctor will probably recommend some lifestyle changes to keep your heart healthy. He or she may advise you to:
- Quit smoking and stay away from secondhand smoke.
- Follow a heart-healthy diet.
- Be active. Ask your doctor what level and type of exercise is safe for you. You may need to avoid intense activity.
- Stay at a healthy weight, or lose weight if you need to.
Your doctor will see you regularly to check on your heart. In some cases, doctors prescribe medicine to lower blood pressure and delay the advance of the disease.
If regurgitation is severe, if symptoms appear, or if your heart does not pump as well, you will probably need valve replacement surgery.