What is aortic valve regurgitation?
Aortic valve regurgitation occurs when your aortic valve doesn’t close securely and blood flows back into the left ventricle (the main pumping chamber). Regurgitation refers to the heart valves leaking — either when the blood flows back through the valve as the leaflets close or when blood leaks through the leaflets when they are closed.
It important to be closely monitored by your doctor to ensure you are on the appropriate treatment plan. If left untreated, aortic valve regurgitation can lead to heart failure, heart arrhythmias, endocarditis or death.
Causes of aortic valve regurgitation
If you have a condition that could damage any of the heart valves (aortic, mitral, tricuspid or pulmonary), you have a greater risk of developing an aortic valve regurgitation.
Conditions that could cause an aortic valve regurgitation include:
- Congenital heart defect — some infants are born with a bicuspid valve (an aortic valve that is missing a cusp) and may develop aortic valve disease later in life.
- Endocarditis — having an infection in the heart creates a higher risk for developing aortic valve regurgitation.
- Rheumatic fever — rheumatic fever, a complication of strep throat, can damage the aortic valve and cause regurgitation.
Other potential causes of aortic valve regurgitation include:
- Trauma — any trauma that damages the aorta near the aortic valve can put you at greater risk for developing aortic valve regurgitation.
- Age-related heart changes — as the heart ages, calcium builds up on the aortic valve which could cause regurgitation.
Risk factors for aortic valve regurgitation
Factors that increase your chance of developing an aortic valve regurgitation include:
- Sex — males are more likely to have aortic valve regurgitation.
- Age — older people are more likely to develop aortic valve regurgitation.
- Health problems — individuals with health conditions such as autoimmune disease, high blood pressure or Marfan syndrome are more likely to develop aortic regurgitation.
- Family history — if a family member has a congenital aortic valve defect, you are also at risk of developing one.
Symptoms of aortic valve regurgitation
Symptoms of aortic valve regurgitation may not appear for many years. As the disease progresses, symptoms include:
- Heart palpitations
- Chest pain
- Shortness of breath
- Fainting or dizziness
- Swollen ankles or feet
- Difficulty breathing when lying down
Diagnosis of aortic valve regurgitation
In most cases, aortic valve regurgitation can be diagnosed by your doctor in a physical exam. During the exam, your physician will check your pulse, listen for heart murmurs or other abnormal sounds and check your blood pressure.
To confirm the diagnosis, your doctor may order a diagnostic test such as:
- Echocardiogram (echo) — takes pictures of your heart to determine if the heart valves are leaking.
- Electrocardiogram (ECG or EKG) — can detect heart arrhythmias.
- Chest x-ray — can show an enlarged left ventricle.
- Cardiac catheterization — can determine how much blood is leaking from the aortic valve.
- Exercise stress test with electrocardiogram — can evaluate how the heart responds to exercise.
Treatment for aortic valve regurgitation
Treatment for aortic valve regurgitation ranges from regular monitoring to surgery.
As the disease progresses and symptoms worsen, you will likely need to have surgery. Surgery may also be recommended in some patients who are not having symptoms if there are concomitant conditions that need to be treated. Mild cases of aortic valve regurgitation can follow a regular monitoring schedule.
If surgery is required, your cardiologist will determine if repair or replacement is the best option for your case. Less invasive catheter-based procedures can be used to replace a damaged tissue valve. Research is being done to determine if catheter-based procedures can be a first-line therapy of treatment for aortic valve regurgitation. Although in many cases open-heart surgery will be necessary.
- Aortic surgical valve repair — may involve separating cusps that are fused or removing valve tissue to allow the cusps to close tightly.
- Aortic valve replacement — involves replacing the damaged aortic valve and replacing it with a mechanical or tissue valve from a pig, cow or human heart.
There are risks and benefits of using both mechanical and tissue to replace the aortic valve. Your doctor will evaluate your case to determine the best option for you.