What is aortic regurgitation?
Aortic regurgitation, or aortic insufficiency, is a type of heart valve disease that affects the aortic valve and the flow of blood through it to the heart. The aortic valve has flaps (called cusps or leaflets) that control the blood flow through the valve. If those flaps fail to close tightly, the result is a leaky aortic valve, causing aortic insufficiency.
Aortic regurgitation allows some of the blood that was pumped out of the left ventricle to leak back in. As the left ventricle works harder to keep pushing blood through the aortic valve, it may eventually become enlarged and weakened. A weakened left ventricle may lead to heart failure.
Symptoms of aortic regurgitation
When your heart initially compensates for the leaky aortic valve, you may not notice any symptoms. As the condition worsens, aortic regurgitation symptoms may include:
- Chest pain: you might feel discomfort and tightness that increases with physical activity.
- Fatigue: with increased activity, you may feel tired and weak.
- Shortness of breath: you may have a hard time breathing deeply, especially when lying down or after being active.
- Swollen ankles and feet: swelling may occur when the flow of blood is disturbed.
- Fainting or lightheadedness: you may feel dizzy or even lose consciousness during physical activity.
- Heart murmur: this abnormal heart sound is heard through a stethoscope.
- Heart palpitations: you may feel sensations of rapid, fluttering heartbeat.
What causes aortic regurgitation?
There are several causes of aortic regurgitation. Risks for this condition may be present at birth, as a congenital heart condition, or develop later in life. Typically, this condition develops gradually but aortic insufficiency can occur suddenly for those that may not have any of the known risks.
Causes of aortic regurgitation include:
- Congenital heart valve disease: conditions like bicuspid aortic valve or other genetic heart conditions that affect the aortic valve’s structure or number of leaflets
- Aortic stenosis: calcium buildup on the aortic valve that causes the valve to narrow and prevents the valve from opening and closing properly
- Endocarditis: a life-threatening condition in which the heart chamber’s lining and valves become inflamed
- Rheumatic fever or rheumatic heart disease: a rare complication of strep throat that can cause the aortic valve to stiffen and narrow (stenosis)
- Other diseases: conditions like Marfan syndrome and lupus that are at risk of an enlarged aorta
- Trauma: ctructural changes to the aortic valve caused by a physical injury
How is aortic regurgitation diagnosed?
If your doctor suspects an aortic insufficiency, they will use echocardiography and cardiovascular imaging techniques including:
- Transthoracic echocardiogram (TTE)
- Electrocardiogram (ECG)
- Cardiac magnetic resonance imaging (MRI)
- Cardiac catheterization
- Transesophageal echocardiogram (TEE)
- CT scan
Aortic regurgitation treatment options at Penn Medicine
Penn Medicine’s cardiovascular team evaluates the severity of your aortic regurgitation and creates a personalized treatment plan. For mild aortic insufficiency, our cardiologists and imaging professionals monitor your condition at regular appointments. If you have symptoms, your doctor may recommend medication or lifestyle changes.
If your regurgitation progresses, your cardiologist may recommend repairing your aortic valve. Our surgeons repair aortic regurgitation when most other health systems cannot. Our cardiac team performs valve replacement for regurgitation if you are also diagnosed with severe aortic stenosis.
Penn Medicine’s surgeons and cardiologists treat aortic regurgitation with procedures including:
- Aortic valve repair or replacement surgery: An open-chest procedure to repair the valve
- Paravalvular leak closure: A nonsurgical procedure to repair a previously replaced aortic valve that is now leaking
Living with aortic regurgitation
Your prognosis after being diagnosed with aortic regurgitation is dependent on many factors including your general health, how your condition has progressed, and if you’ve developed heart failure. Your healthcare provider will be able to discuss your specific prognosis and offer guidance for how best to manage your condition. Some lifestyle changes that may help improve your quality of life include:
- Regularly taking all medications prescribed by your doctor
- Eating a heart-healthy diet
- Exercise regularly as indicated by your provider
- Avoid tobacco or quit smoking
- Don’t use recreational drugs
- Maintain regular visits with your doctor to monitor your condition
- Visit the dentist regularly and maintain good oral health to prevent endocarditis (an infection of the heart valves)
Preventing aortic regurgitation
For some, aortic regurgitation can be caused by congenital heart disease and is present a birth and therefore cannot be prevented, however, others can develop heart disease over time. You can lower your risk for heart disease like aortic regurgitation by:
- Exercising regularly, or as indicated by your doctor
- Don’t smoke
- Avoiding recreational drugs
- Visiting your doctor right away if you develop an infection
- Taking your medications as indicated by your doctor
- Controlling high blood pressure