Treatment for aortic valve regurgitation usually depends on whether you have symptoms from your leaky heart valve and whether your heart is pumping effectively. Other factors that play a part in treatment decisions include your age (older people may be at greater-than-average risk for complications of some treatments), risks associated with surgery, and the experience of the doctor and health care facility performing the procedures.

If you have symptoms, surgical treatment may be needed. If your symptoms develop suddenly (acute aortic regurgitation), immediate surgery to replace the valve is usually needed.

Since the treatment for acute aortic regurgitation is usually limited to immediate surgery, this treatment overview will discuss the treatment of chronic aortic valve regurgitation.

Initial treatment

Your doctor will assess the cause and severity of your aortic valve regurgitation and how effectively your heart is able to compensate for it. In addition to some preliminary tests-including routine blood tests and an electrocardiogram-an exercise electrocardiogram (also called exercise EKG or cardiac stress test) can be done to see whether you have any symptoms while you are exercising. After these tests, an echocardiogram will probably be done to estimate your ejection fraction, which is a measure of the left ventricle's ability to fill with blood and pump properly. This measurement will help your doctor determine when surgery is needed.

If your regurgitation is mild and you do not have any symptoms, your doctor may not prescribe daily heart medications. If you have had rheumatic fever, you may need to take antibiotics daily for the following 5 to 10 years, depending on your heart's condition.

If your regurgitation is moderate to severe, your doctor may prescribe the calcium channel blocker nifedipine (such as Procardia), an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), or the vasodilator hydralazine (Apresoline). These medications, which are typically prescribed for high blood pressure, have been shown to slow the progression of aortic valve regurgitation and delay the need for valve replacement surgery.

Since your heart is already working overtime to keep up with your body's needs, your doctor will probably recommend specific lifestyle changes to decrease your heart's workload.

• If you smoke, your doctor will strongly advise that you quit and avoid secondhand smoke too. Your doctor may prescribe medication and therapy to help you quit smoking. Studies show that the combination of nicotine replacement therapy, use of the medication bupropion (Zyban or Wellbutrin), and supportive therapy significantly increases long-term success in quitting.¹ For more information, see the topic Quitting Tobacco Use.
• Your doctor will also recommend that you follow a heart-healthy diet and get regular exercise. If you do not have symptoms of aortic valve regurgitation, your doctor may recommend regular, light aerobic exercise, such as walking. But do not start an exercise program on your own without first discussing it with your doctor. If you can exercise, do activities that raise your heart rate. Exercise for at least 30 minutes on most, preferably all, days of the week.
• Good dental hygiene and regular dental checkups are important, because poor dental health can increase the risk of bacteria spreading to your heart.
• Avoid getting sick from the flu. Get a flu shot every year.