Aortic Regurgitation

Overview, Causes, & Risk Factors

Aortic regurgitation is a condition in which blood flows backwardsinto the left side of the heart through the aortic valve. The aortic valve is aflap-like opening located between the left side of the heart and the aorta. Theaorta is the main artery carrying blood from the heart.

What is going on in the body?

The heart is divided into two halves, right and left. Each side has a pumpingchamber, called a ventricle. The left ventricle receives blood from the lungs.During a heartbeat, the left heart chamber squeezes, generating enough pressureto open the aortic valve. Blood from the left side is then pumped into theaorta and out into the body for general circulation. As the left heart chamberempties, the aortic valve closes.

In a normal heart, the valve seals shut, and no blood is allowed to flow backinto the left side. But when the aortic valve is abnormal, blood does flowbackwards. This causes blood to flow into the left heart chamber from twosources. The first source is from the lungs, which is normal. The second sourceis from the backflow of blood across the leaky aortic valve. When the heartreceives this excess amount of blood, the left side must work harder. Thisexcess work can stress the left side of the heart and cause it to enlarge. Thisdamage can happen slowly over time, or can get worse rather quickly.

What are the causes and risks of the condition?

There are many causes of aortic regurgitation. Some of the more common onesinclude:

  • ankylosing spondylitis, a spinal disorder
  • aortic dissection, a tear in the aorta that allows blood to flowbetween the inner and outer layers
  • congenital heart defects that are present atbirth
  • high blood pressure
  • infective endocarditis, an infection in the valves or lining of theheart
  • Marfan syndrome, an inherited disease that weakens body tissues
  • Reiter syndrome, an arthritic disorder that affects adult males
  • rheumatic fever, a disease that can cause arthritis andheart problems
  • rheumatoid arthritis,which also causes joint pain and swelling
  • Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\syphilis, a sexuallytransmitted disease (STD)
  • systemic lupuserythematosus, an autoimmune disorder in which the person creates antibodies againsthis or her own tissues
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Aortic regurgitation usually progresses slowly over years. Manypeople do well despite moderate to severe regurgitation of the aortic valve.Symptoms may not appear until the left heart chamber is quite stressed. Commonsymptoms include:

  • abdominal discomfort
  • chestpain
  • excessive sweating
  • palpitations, or an unusual awareness of the heart beating in thechest
  • shortness of breath that worsens with exertion or lying down
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of aortic regurgitation begins with a history andphysical exam. The healthcare provider also may do one or more of these tests:

  • cardiac catheterization
  • chestX-ray
  • echocardiogram with or without color Doppler studies
  • electrocardiogram (EKG)
  • Prevention & Expectations

    What can be done to prevent the condition?

    Some cases of aortic insufficiency can be prevented by treatingunderlying disorders. For example, effective treatment of autoimmune disorders may preventsome damage to the aortic valve. Highblood pressure can be managed with lifestyle changes and medicines.Following safer sex guidelines can prevents some STDs.

    What are the long-term effects of the condition?

    Aortic regurgitation may worsen if a person has a heart infectionor aorticdissection. The function of the left heart chamber may deterioratequickly within a few weeks or months. Chronic regurgitation usually progressesslowly. It can cause severe congestiveheart failure, or CHF.

    What are the risks to others?

    Aortic regurgitation is not contagious and poses no risk toothers.

    Treatment & Monitoring

    What are the treatments for the condition?

    Medicines to improve the pumping action of the heart may be givento reduce the severity of the regurgitation. This treatment may postpone oravoid surgery in people who don’t have symptoms. Heart valve surgery may be needed for some peoplewhen there are signs that the left heart chamber isn’t working well.

    What are the side effects of the treatments?

    Medicines used to treat aortic regurgitation can cause a varietyof side effects. Surgery can cause bleeding, infection, or allergic reaction to anesthesia.

    What happens after treatment for the condition?

    If a person does not have symptoms and the left heart chamberworks well, he or she may remain on medicine for a long time.

    Successful replacement of the valve restores normal blood flow. The long-termoutcome is usually very good. Artificial valves wear out over a period ofyears. Their function is monitored, and the valves are replaced as necessary.Some artificial valves require that the person take:

  • antibiotics before and after surgeries or dental work to avoid seriousheart infections
  • blood-thinning drugs to avoid blood clots, such as deep venousthrombosis
  • How is the condition monitored?

    An individual with aortic regurgitation will have regular visitswith the healthcare provider. The provider may order regular electrocardiograms and echocardiograms to detect any signsof deterioration. Any new or worsening symptoms should be reported to theprovider.

    Article type: xmedgeneral

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