Aortic Valve Regurgitation

Last updated April 9, 2016

What are the other Names for this Condition? (Also known as/Synonyms)

  • Aortic Incompetence
  • Aortic Insufficiency
  • Nonrheumatic Aortic (Valve) Incompetence, NOS

What is Aortic Valve Regurgitation? (Definition/Background Information)

  • The heart pumps blood in and out of the heart. There are valves that prevent the blood from flowing the wrong way. If due to any reason, the valve (specifically the valve located on the aorta that controls the blood flow out of the left ventricle) does not close properly, then there is a backward flow of blood into the heart (called regurgitation). This condition is known as Aortic Valve Regurgitation
  • This health problem is caused due to many heart-linked factors, or secondary infections. It may be chronic, or can occur suddenly
  • The condition, also termed as Aortic Regurgitation, may be of varying intensities. Acute cases of the condition may prove to be fatal, if immediate medical attention is not administered

Who gets Aortic Valve Regurgitation? (Age and Sex Distribution)

Aortic Valve Regurgitation is generally seen in young and old male adults, between the ages of 30 and 60 years.

What are the Risk Factors for Aortic Valve Regurgitation? (Predisposing Factors)

Some of the potential risk factors for Aortic Valve Regurgitation are:

  • Damage to the heart valves, due to endocarditis, rheumatic fever
  • Stress and other physical factors, causing a high blood pressure
  • Congenital defects; children born with malformed aortic valves have a high risk
  • Certain diseases and disorders may cause the heart valves to widen. These include syphilis, Marfan syndrome, ankylosing spondylitis (a skeletal defect of the vertebrae), etc.
  • Women with this condition are at a higher risk, if they become pregnant. They may need to be constantly monitored, even after delivery of the child

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Aortic Valve Regurgitation? (Etiology)

Aortic Valve Regurgitation is caused due to a variety of factors, chiefly:

  • Being born with a congenital heart condition
  • High blood pressure may damage the heart or dilate the aorta, and also thicken the arteries
  • Rheumatic fever
  • Injury/trauma to the heart valve
  • Age is a significant factor that causes a deterioration of the aortic valves
  • Heart failure, infection of the heart (endocarditis)
  • Diseases and conditions, such as Syphilis, Marfan syndrome, and ankylosing spondylitis, may cause widening of the valves

What are the Signs and Symptoms of Aortic Valve Regurgitation?

Signs and symptoms of Aortic Valve Regurgitation are:

  • Severe to critical cases of Aortic Regurgitation may cause blood circulatory problems (cyanosis) and very low blood pressures, with rapid heartbeat
  • Chest pain (angina) and irregular heartbeat patterns
  • Coughing, due to breathing trouble or shortness of breath, while sleeping, or coughing quite unexpectedly without much exertion
  • Fatigue, feeling faint (sometimes)
  • Fluid in the lungs
  • Often, signs of Aortic Valve Regurgitation bear resemblance to those of a congestive heart failure

How is Aortic Valve Regurgitation Diagnosed?

Early detection and treatment of the condition is essential; since with time, the Aortic Valve condition may progress from a mild case to being a severe one.

A physical evaluation of the individual’s heart is undertaken, once the physician suspects the disorder. The basic sequence of diagnosis is:

  • Listening to the heartbeat, using a stethoscope, to detect any unusual sound (blood leakage through the valve, abnormal beats, heart murmur)
  • Test pulse rate and blood pressure values
  • Evaluation of personal and family history for related heart conditions

A cardiologist may then plan the type of tests that are required. Sometimes, various exercises are used to measure the heart’s response to physical activities.

  • A pulmonary x-ray may reveal a swollen left ventricle - the size and shape of the heart can be studied with this mode
  • Echocardiogram and MRI of the heart, are a few of the imaging studies used
  • A catheter may be inserted into the left ventricle of the heart to study/diagnose the condition
  • A picture of the heart and the aorta is obtained by passing a transducer (like an endoscope), through the esophagus. This method is used to understand the condition of the heart and aorta and is called transesophageal echocardiogram
  • After injecting special dyes into the body, x-ray studies are used to evaluate the flow of blood out of the heart through the aorta. This is known as aortic angiography
  • Differential diagnosis may be necessary, when other heart complications are present

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Aortic Valve Regurgitation?

Complications due to mild Aortic Valve Regurgitation are generally rare, but if the condition is severe, then their effects could be serious. The complications include:

  • Heart failure
  • Endocarditis - a kind of heart infection caused by inflammation of the heart walls or inner linings
  • Arrhythmias, when the heart beats irregularly

How is Aortic Valve Regurgitation Treated?

Treatment of Aortic Valve Regurgitation is based on the condition of the heart, the overall health condition of the individual, and the signs and symptoms presented (whether they are mild, moderate, or severe):

  • Surgical procedures to either repair or replace the heart valves, are normally resorted to, when the symptoms and heart function/heart condition do not appear encouraging
  • Surgery is also advocated to prevent Aortic Valve Regurgitation from progressively worsening and creating life-threatening situations
  • Moderately affected individuals may be administered medications, such as ACE inhibitors and diuretics (substances that increase the rate of fluid flow from the body - also called water pills), to keep the problem under check, and also control the buildup of fluid
  • If the individual presents with mild symptoms, then regular and periodic evaluation of the condition (using an echocardiogram) is prescribed; being vigilant is of importance here
  • Avoidance of stressful situations and physical activities, keeping the blood pressure regularly under control, are particularly important

How can Aortic Valve Regurgitation be Prevented?

Individuals with Aortic Valve Regurgitation, have to always maintain their blood pressure under control and within acceptable levels, to prevent any valve regurgitation.

  • Germs in the bloodstream, due to poor oral hygiene, are a leading cause of endocarditis - a heart condition that causes damage to the heart valves. Hence, keeping the gums and teeth in good hygienic condition (oral hygiene) is essential
  • Rheumatic fever is said to cause Aortic Regurgitation. Therefore, taking care of your sore throat or bacterial throat infection, is one way to ensure that rheumatic fever does not develop
  • Smoking has to be completely avoided
  • Follow a healthy diet for the heart
  • Maintain a healthy weight and avoid obesity

What is the Prognosis of Aortic Valve Regurgitation? (Outcomes/Resolutions)

  • Mild forms of Aortic Valve Regurgitation may be asymptomatic, however they still require medical attention
  • For severe cases, surgical intervention is recommended - this can rectify the problem, if no additional complications develop
  • If treatment is delayed or is not provided, then it may be fatal for individuals with angina, or those suffering from other heart conditions, heart failures, etc.

Additional and Relevant Useful Information for Aortic Valve Regurgitation:

A healthy lifestyle improves the quality of heart life. Light exercising (walking, swimming, as recommended by the physician), periodic health check-ups (both with a cardiologist and a dentist), keeping blood pressure under control, and using less oil and salt in the diet, are all good health practices.

What are some Useful Resources for Additional Information?

American Heart Association (AHA)
7272 Greenville Ave. Dallas, TX 75231
Phone: 1-800-AHA-USA-1, 1-800-242-8721, 1-888-474-VIVE
Email: Review.personal.info@heart.org
Website: http://www.heart.org

References and Information Sources used for the Article:

http://www.nlm.nih.gov/medlineplus/ency/article/000179.htm (accessed on 10/01/12)

http://www.mayoclinic.com/health/aortic-valve-regurgitation/DS00419 (accessed on 10/01/12)

Helpful Peer-Reviewed Medical Articles:

Ginghina, C., Aschie, D., Calin, A., Popescu, B. A., Calin, C., Stoian, F., . . . Iliescu, V. A. (2012). Aortic regurgitation due to quadricuspid aortic valve--case report and literature review. [Case Reports Review]. Chirurgia (Bucur), 107(2), 260-264.

Komatsu, K., &Higami, T. (2007). [Aortic valve regurgitation associated with heart failure]. [Review].Nihon Rinsho, 65 Suppl 5, 495-502.

Sochman, J., &Peregrin, J. H. (2008).Catheter-based management of aortic valve regurgitation in experimental cardiology. [Historical Article Research Support, Non-U.S. Gov't Review]. Physiol Res, 57(3), 321-326.

Tweddell, J. S., Pelech, A. N., &Frommelt, P. C. (2006). Ventricular septal defect and aortic valve regurgitation: pathophysiology and indications for surgery. [Review].SeminThoracCardiovascSurgPediatr Card SurgAnnu, 147-152. doi: 10.1053/j.pcsu.2006.02.020

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Dec. 10, 2013
Last updated: April 9, 2016

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