What is Aortic Regurgitation?

Medically Reviewed by James Beckerman, MD, FACC on March 15, 2023
4 min read

Your heart has four chambers, and each one has a valve that allows blood to exit.

When healthy, the valves open wide to let blood move freely on its round-trip through the heart and body. The valves should then shut tightly until the next heartbeat.

But sometimes, the leaflets (also known as cusps) that open and close in a valve don’t close as tightly as they should. As a result, some blood leaks back into the chamber instead of moving on its way. This is known as valve regurgitation.

The last of the four valves that blood passes through before leaving the heart is the aortic valve. If you have advanced aortic valve regurgitation, the problems it might cause can be serious.

Doctors may treat mild aortic valve regurgitation with medications and by carefully tracking how you’re doing.

Aortic valve regurgitation has several causes. Among them are:

Rheumatic fever: Strep throat can turn into rheumatic fever if it’s not properly treated. Rheumatic fever, which was once much more common in childhood than it is today, can damage your aortic valve. It is the most common cause of serious aortic valve regurgitation among older adults.

Congenital heart defect: Most aortic valves have three cusps. A somewhat common heart defect that people are born with is an aortic valve that has only two cusps or leaflets. Many mild cases of aortic valve regurgitation are caused by these “bicuspid aortic valves.”

Endocarditis: This type of heart infection usually starts from somewhere else in the body. Germs or bacteria travel in the blood to the heart and cause it harm. The valves are especially vulnerable.

Aortic valve stenosis: This happens when your aortic valve can’t open all the way because it has become too thick and stiff. Sometimes, this condition can also make it harder for the valve to close the right way, causing regurgitation.

Aortic regurgitation can be going on for a long time without any obvious symptoms. They may appear suddenly or come on more gradually. The symptoms include:

Survivors of rheumatic fever and adults born with a congenital heart defect have a greater chance for aortic regurgitation. You also have a greater likelihood if you have high blood pressure, which can damage the part of the aorta where it meets the aortic valve.

Older adults are more likely than younger people to get this condition, because the leaflets tend to stretch over time.

The most serious potential complication from aortic valve regurgitation is heart failure, which is when your heart muscle weakens and can’t pump blood properly to your body.

Heart failure can then lead to complications with your other organs.

Aortic regurgitation can also raise your risk of getting endocarditis, an infection of the inner lining of the heart.

Even if you don’t have symptoms, your doctor may be able to detect aortic regurgitation by listening to your heart with a stethoscope.

If your doctor hears a whooshing sound in between beats, it could mean you have valve problems. The whooshing sound means there is an abnormal flow of blood through the valve.

If they suspect aortic regurgitation, your doctor may order one or more of the following tests:

  • Echocardiogram: Sound waves aimed at your heart create a video of it as it beats. This imaging test can help find aortic regurgitation and determine how seriously it’s interfering with healthy blood flow.
  • Chest X-ray: This can often tell if your heart is enlarged, possibly because of aortic regurgitation. An X-ray can also show whether your lungs have been affected by blood backing up in your heart.
  • Cardiac catheterization: Your doctor inserts a flexible tube called a catheter through an artery and into your heart. Your doctor may use special dye and an X-ray “movie” to get a more detailed look at your heart’s valves and chambers.

Mild regurgitation may not require any treatment. Simply monitoring it regularly through your usual checkups may be enough.

If you have high blood pressure, you may get medications and make some lifestyle changes to bring it under control.

In more serious cases, aortic valve replacement may be the best option.

This can be done with traditional, open surgery or with a relatively newer procedure known as transcatheter aortic valve replacement (TAVR).

You do not have your chest opened with TAVR. Instead, your doctor uses a catheter that travels through an artery to the aortic valve.

Your doctor inserts a replacement valve at the site of your defective valve. Once the new valve is in place, your doctor takes out the catheter, and your heart continues to work as it once did.

There are no guaranteed ways to prevent aortic valve regurgitation. If you have strep throat, get treated before it progresses to rheumatic fever. Keeping your blood pressure in the healthy range is also important.

In general, to keep your heart working as well as it should, get into good habits: