Aortic regurgitation is the medical term used to describe the backward flow of blood through the aortic valve. The aortic valve sits at the outlet of the left side of the heart (the left ventricle) and controls the flow of blood out of the heart and to the body. All of the four valves of the heart are designed to work like one-way valves to control the forward flow of blood. It is not unusual to have no symptoms from aortic regurgitation. If a person has symptoms, he or she generally feels fatigued or short of breath. Aortic regurgitation can happen suddenly if something happens to the valve, or can increase slowly over a longer period of time. If you are having symptoms of aortic regurgitation, generally the valve needs to be surgically replaced. Aortic regurgitation can be caused by congenital heart defects (abnormal heart conditions present since birth), normal aging of the valve causing deterioration, endocarditis (infection of the heart valve), rheumatic fever (which comes from strep throat that infects the heart valves), or other causes. Over time, the heart has to pump harder to get enough blood to the body which can lead to weakening of the heart including a condition called congestive heart failure. Having aortic regurgitation, or any other valve abnormality in the heart can make you more likely to having an infection like endocarditis.
Fatigue, weakness, shortness of breath, chest pain, chest discomfort, dizziness, fainting, palpitations, swelling in the ankles and feet, fast pulse, irregular pulse
Your doctor will talk to you about your history and perform a physical exam. During the physical exam, your doctor will pay particular attention to listening to your heart sounds and checking for signs of heart failure, like swelling in your legs. Your doctor may want to do a test called an EKG. An EKG is done by placing small stickers over the chest which are attached to a machine to create a picture of the electrical activity of the heart. Your doctor or cardiologist will probably also want to do an echocardiogram (ultrasound or sonogram) of the heart which can show how the valves of the heart are working and if the blood flow is going in the right direction. The echocardiogram can also tell your doctor how severe your aortic regurgitation is and whether you may need treatment. An echocardiogram is generally done on the surface of the chest first, but can be also done from inside the esophagus (the tube that connects the mouth to the stomach) if your doctor needs a better picture of the heart. Your doctor may also recommend a special type of exercise stress test which involves exercising to test how your heart responds to increased work. Your cardiologist may also recommend a cardiac catheterization. During this procedure, a thin wire is placed in one of the blood vessels in the leg or wrist and fed up to the heart. The cardiologist then injects dye through that small wire and takes pictures of the arteries of the heart and the flow of blood in the heart. All of these tests can help your doctor determine the degree of your valvular problem and whether your valve needs to be replaced.
Your doctor will recommend treatment for your aortic regurgitation based on how severe your aortic regurgitation is. Treatment can range from waiting and observing your condition over time to replacing the valve. If your aortic regurgitation does not cause any symptoms and is not very severe, your doctor will continue to monitor you over time. No medications can treat aortic regurgitation, but your doctor may recommend certain medications to control symptoms caused by your aortic regurgitation like pills to help remove fluid from your legs. You may also need antibiotics if you are having a dental procedure done in order to prevent infections of the heart valve called endocarditis. If your aortic regurgitation is severe or causes symptoms, your doctor or cardiologist may recommend surgery. Aortic valve surgery is done by a cardiothoracic surgeon. Surgery can be done by either repairing the leaky valve or replacing it. Replacement valves can be made from metal or made from tissue. With some types of replacement valves, you will need to take a blood-thinning medication for the rest of your life. After aortic valve replacement, most people can return to a normal life.
