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Aortic valve regurgitation is a problem with the aortic valve. The aortic valve allows blood to flow from the heart's lower left chamber (ventricle) into the aorta and to the body. When the heart rests between beats, the valve closes to keep blood from flowing backward into the heart.
When you have aortic valve regurgitation, the aortic valve doesn't 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.
You can have this problem for a long time and not know it. It may take years for symptoms to start. This is called chronicaortic valve regurgitation. In rare cases, the valve problem starts suddenly and without warning. This is called acuteaortic valve regurgitation. It requires medical help right away.
Any condition that damages the aortic valve can cause aortic valve regurgitation. Common causes of chronic valve problems include:
The most common causes of sudden (acute) aortic valve regurgitation include:
For chronic regurgitation, you may not have any symptoms at first. But over time you may have:
If you start to notice any of these symptoms, let your doctor know right away.
When the valve problem is acute, these symptoms are sudden, often more intense, and life-threatening.
Your doctor may suspect that you have this type of valve problem after hearing a heart murmur through a stethoscope. He or she will ask about your symptoms and past health and will want to know if you have any family history of heart disease.
You will get further tests, like an echocardiogram to confirm the diagnosis, to show how much the valve is leaking, and to see how well the left ventricle is working.
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 starts slowly. Your doctor will probably recommend some lifestyle changes to keep your heart healthy. He or she may advise you to:
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 regurgitation is severe, if symptoms appear, or if your heart does not pump as well, you will probably need valve replacement surgery.
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Different factors cause sudden (acute) and long-standing (chronic) aortic valve regurgitation.
Causes of chronic aortic valve regurgitation include:
Acute regurgitation can be caused by:
You may not have any symptoms for a long time. When symptoms do appear, it may mean that your heart is severely affected. See a picture of aortic valve regurgitation.
If you start to notice symptoms, let your doctor know right away.
There's no way to tell how quickly symptoms will develop. Some people stay free of symptoms for decades. For others, symptoms may develop over 2 to 3 years.
Symptoms of aortic valve regurgitation include:
These symptoms are sudden, often more intense, and life-threatening. Acute aortic valve regurgitation is an emergency.
The risk factors for aortic valve regurgitation are:
Tell your doctor if one of your close family members has a congenital aortic valve defect. This may also increase your risk.
Call your doctor if you have symptoms of aortic valve regurgitation such as fainting, chest pain, or shortness of breath. Your doctor will confirm whether you have valve problems or some other condition. For more information, see Symptoms.
Acute aortic valve regurgitation comes on suddenly. Symptoms include severe shortness of breath, a rapid heart rate, lightheadedness, weakness, confusion, and chest pain.
Acute aortic valve regurgitation is a medical emergency. Call 911 immediately.
Health professionals who can diagnose aortic valve regurgitation include:
After you have been diagnosed, you may be referred to a cardiologist, who specializes in heart diseases. The specialist will monitor your condition and help determine when valve replacement is needed.
Tests for aortic valve regurgitation can assess how severe the regurgitation is and whether you have any complications, such as abnormal heartbeats (arrhythmias) or heart failure.
Aortic valve regurgitation can typically be diagnosed by physical exam. Your doctor will check your blood pressure, pulse, and listen for abnormal sounds in your heart and lungs.
Other tests may include:
Severity of aortic valve regurgitation
How often you should have an echocardiogram
Every 3 to 5 years
Every 1 to 2 years
At least every 6 to 12 months
Treatment for aortic valve regurgitation usually depends on whether you have symptoms from your leaky heart valve and how well your heart is pumping. Other things that affect treatment include your age and risks related to surgery.
After your diagnosis, you'll probably have tests, such as an electrocardiogram or an echocardiogram.
You'll need regular echocardiogram tests as part of your treatment. Your doctor will let you know how often you'll get these tests. For more information, see Exams and Tests.
If you have any chest pain or pressure, fainting, or shortness of breath, be sure to tell your doctor right away. He or she will rely on your report of how you feel and how your symptoms are changing.
Medicine cannot treat the leaky heart valve. But you might take medicine to lower blood pressure. If you have an artificial heart valve, you might take medicine to prevent infection or blood clots. For more information, see Medications.
Because your heart is already working hard to keep up with your body's needs, your doctor will probably recommend that you make some healthy lifestyle changes. These include eating a heart-healthy diet and not smoking. For more information, see Living With Aortic Regurgitation.
You might have surgery to replace your aortic valve if your regurgitation is getting worse. You might have surgery before you get symptoms. If you have acute regurgitation, surgery may be done right away. For more information, see Surgery.
You may want to consider the type of care you wish to receive in case you are unable to make your wishes known. For more information, see the topic Care at the End of Life.
Having aortic valve regurgitation means that your heart is working overtime to keep up with your body's needs. Your doctor will probably suggest lifestyle changes to help your heart.
Treatment for chronic aortic valve regurgitation includes medicines to reduce blood pressure. If you have valve replacement surgery, you may need to take medicines to prevent infection and blood clots around the artificial valve.
If you have valve replacement surgery, you may need:
Valve replacement surgery can fix aortic valve regurgitation. Surgery to repair the aortic valve, instead of replacing it, is not commonly done. Having surgery is a big decision. To help decide when you need surgery, you and your doctor will look at your overall health, your heart health, and how severe your regurgitation is.
Your doctor will check:
If you need some other heart surgery, such as bypass surgery, your doctor may suggest valve replacement at the same time.
Even if you don't have symptoms, your doctor may suggest surgery. Most of the time, symptoms only occur when the heart is already damaged. Learn more about deciding about surgery for aortic valve replacement.
If you have surgery, a mechanical or tissue valve will be used to replace your heart valve. Before you have surgery, you and your doctor will decide on which type of valve is right for you. To help with this decision, see:
CitationsNishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.Other Works ConsultedFreeman RV, Otto CM (2011). Aortic valve disease. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 2, pp. 1692-1720. New York: McGraw-Hill.Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.Oakley RE, et al. (2008). Choice of prosthetic heart valve in today's practice. Circulation, 117(2): 253-256.Otto CM, Bonow RO (2012). Valvular heart disease. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1468-1539. Philadelphia: Saunders.Rosengart TK, et al. (2008). Percutaneous and minimally invasive valve procedures: A scientific statement from the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation, 117(13): 1750-1767.Stewart WJ, Carabello BA (2007). Aortic valve disease. In EJ Topol et al., eds., Textbook of Cardiovascular Medicine, 3rd ed., pp. 366-388. Philadelphia: Lippincott Williams and Wilkins.Stout KK, Verrier ED (2009). Acute valvular regurgitation. Circulation, 119(25): 3232-3241.Whitlock RP, et al. (2012). Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic therapy and prevention of thrombosis, 9th ed.-American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2, Suppl): e576S-e600S.
ByHealthwise StaffPrimary Medical ReviewerRakesh K. Pai, MD - Cardiology, ElectrophysiologyMartin J. Gabica, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerMichael P. Pignone, MD, MPH, FACP - Internal Medicine
Current as ofDecember 6, 2017
Current as of: December 6, 2017
Author: Healthwise Staff
Medical Review: Rakesh K. Pai, MD - Cardiology, Electrophysiology & Martin J. Gabica, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Michael P. Pignone, MD, MPH, FACP - Internal Medicine
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