Aortic Valve Regurgitation
Overview
What is aortic valve regurgitation?
Aortic valve regurgitation is a problem with the aortic valve. This valve works like a one-way gate, opening so that blood from the left ventricle (the heart's main pump) can be pushed into the aorta, the large artery leaving the heart. From the aorta, blood flows into the other arteries and through the body. When the heart rests between beats, the aortic valve closes to keep blood from flowing backward into the heart. See a picture of how the aortic valve works
.
But when you have aortic valve regurgitation, the aortic valve does not 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
In most cases, it takes many years for symptoms to start. This is called chronic aortic valve regurgitation. The heart makes up for reduced blood flow by getting bigger so that it can pump out more blood. But if the valve problem is not fixed and the leaking gets worse, symptoms start. At this point, valve replacement surgery is often needed to prevent abnormal heartbeats, heart failure, and permanent damage to the heart.
In rare cases, the valve problem starts suddenly and without warning. This is called acute aortic valve regurgitation. It requires medical help right away.
In some people, only small amounts of blood leak back into the left ventricle. This normally does not cause any symptoms or problems. This topic focuses on the more severe cases where large amounts of blood leak back into the left ventricle.
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 damaged aortic valve.
- Aging.
- Enlargement of the aorta because of high blood pressure or hardening of the arteries.
- Rheumatic fever.
- Damage from radiation treatment (but this is rare).
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 (prosthetic) aortic valve.
- Trauma to the heart valve or aorta.
What are the symptoms?
Early on, people with chronic aortic valve regurgitation often do not have any symptoms. But as the heart pumps harder to make up for the valve problem, the heart gets weaker over time, and symptoms start. These symptoms include:
- 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 (angina), often brought on by exercise, when the heart has to work harder.
- Fainting.
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
You will get further tests, like an electrocardiogram (EKG or ECG) 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 is chronic and starts slowly. So when people are first diagnosed, treatment is not needed. 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.
- Get regular exercise. Walking is a good choice.
- Stay at a healthy weight.
Even when you aren't getting treatment, 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 symptoms appear or your heart does not pump as well, you will probably need valve replacement surgery.
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| Author: | Robin Parks, MS | Last Updated: January 24, 2008 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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