Overview

What is aortic valve regurgitation?

A leaky aortic valve is called aortic regurgitation. When you have this, the leaflets of your aortic valve do not close as snugly as they should. What happens is that some of the blood that should go out of your heart leaks back with each beat of your heart. Aortic regurgitation falls under heart valve diseases that range from mild to severe and must be under careful surveillance by a healthcare provider.

Other names for aortic regurgitation include the following:

Aortic insufficiency
Aortic valve regurgitation
Leaking aortic valve

What happens in aortic insufficiency?

The aortic valve is the "door" regulating blood flow from your heart into your aorta, the largest artery in your body. Every beat of your heart pumps oxygen-rich blood through many branches to various organs and tissues. For all this to happen successfully in nourishing your body, first and foremost, it must leave the heart. That is when the aortic valve comes in.

Your aortic valve opens to allow blood to travel from the left ventricle, your heart's main pumping chamber, into your aorta. This happens every time your left ventricle contracts, which is when it becomes systolic. If your left ventricle relaxes, known as diastole, then your aortic valve closes.

Usually, your aortic valve closes tightly enough to allow blood to flow in the proper direction. However, if you have aortic regurgitation, then your valve will fail to close all the way. Hence, blood seeps backward into the chamber when your left ventricle relaxes.

Mild regurgitation might cause no symptoms or problems. However, with time, the condition may worsen and lead to an overflowing left ventricle outlet. This is because, generally, your left ventricle should only receive blood from your top left heart chamber, known as the left atrium. Your left ventricle is strong enough to handle this volume. However, a leaky aortic valve results in extra blood flowing into your left ventricle, giving it extra work to handle this blood volume.

When it happens suddenly and rapidly, you have acute aortic regurgitation. When it happens slowly over time, then you have chronic aortic regurgitation. Chronic form is very common in the U.S.

What happens inside my body from a leaky aortic valve?

Aortic regurgitation forces your heart's left ventricle to pump much harder than it is normally accustomed to to ensure that enough blood is expelled into your aorta. Over time, this can lead to the muscular walls of your left ventricle becoming thicker or hypertrophied. Left ventricular hypertrophy reduces your heart's efficiency. It leads to conditions such as

Heart failure
Heart attack.

Who gets aortic regurgitation?

Aortic regurgitation can affect virtually anyone, including those who have:

Congenital heart disease, specifically bicuspid aortic valve, or BAV- A congenital condition is a condition you're born with. In people with BAV, the valve between the ages of 20 and 40 often becomes leaky.
Calcified aortic valve- Patients with a calcified aortic valve are usually over 60 years old and have a mixed valve disease abnormality involving more than one valve. In this case, the patient has aortic stenosis with some component of regurgitation.
Previous aortic valve replacement- A bioprosthetic valve wears out over time and will not work.
Rheumatic heart disease- Rheumatic fever leads to rheumatic heart disease, which is one of the leading causes of aortic regurgitation in low- and middle-income countries.

What are the symptoms of aortic regurgitation?

The following symptoms characterize acute aortic regurgitation:

Chest pain.
Heart palpitations.
Shortness of breath with exertion.

Chronic, mild aortic regurgitation is asymptomatic for years. However, as your condition deteriorates, symptoms gradually appear and include:

Chest pain.
Fainting (syncope).
Heart palpitations.
Lightheadedness or shortness of breath can occur with physical exertion, lying down, or when lying in bed and can't sleep.
Swelling (edema) in your ankles and feet.

What causes aortic regurgitation?

Causes of aortic regurgitation include:

Degeneration of the valve from age (the most frequent cause in the United States and Western Europe).
Rheumatic heart disease is the most common cause in most developing countries.
High blood pressure.
Trauma to your chest (such as in a car accident).
Aneurysm of the thoracic aorta.
Aortic dissection.

What are the risk factors of aortic valve regurgitation?

Some anatomical changes, in addition to other diseases of the aortic valve, may contribute to the development of risk factors. You are likely to get a leaking aortic valve if you have these medical conditions:

Bicuspid aortic valve or any other congenital valve defects.
Calcification of your aortic valve flaps
Aortopathy (a disease of the aortic)-It commonly affects the ascending aorta.
History of rheumatic fever or the diagnosis of rheumatic heart disease

How do doctors diagnose aortic regurgitation?

Aortic regurgitation diagnoses are made based on the physical exam and testing provided by your doctor.

During a physical exam, your provider will:

Discuss your personal medical history.
Check your vital signs, including your blood pressure. Obtaining your blood pressure allows your provider to calculate your pulse pressure. The pulse pressure is the difference between the numbers on top and below in your blood pressure, measured in millimeters of mercury (mmHg).
A large pulse pressure of 40 mmHg can be a sign that your aortic valve is leaky. A narrow pulse pressure-one-fourth or less of your number on top-can is an early sign of heart failure.
Listens to your heart (auscultation) with a stethoscope to look for unusual sounds, such as a murmur. If you have aortic regurgitation, your healthcare professional could hear an Austin Flint murmur could hear an Austin Flint murmur if you have aortic regurgitation [24]. This specific murmur was first reported by the physician Austin Flint in 1862. The quick, reversing blood flow into your left ventricle is the source of this.

What tests diagnose this condition?

An echo is the gold standard for diagnosing aortic regurgitation. It uses high-frequency sound waves, or ultrasound, to take pictures of your heart. Your doctor can use several techniques, including Doppler ultrasound, to assess your valve's function. Doppler ultrasound demonstrates the speed and direction of your blood's flow through your heart.

Other tests you might require in diagnosing aortic regurgitation or treatment planning include:

Chest X-ray.
ECG/EKG, Electrocardiogram.
Heart MRI.
Coronary angiogram.

What is the treatment for aortic regurgitation?

Treatment depends on how severe your condition is. If you have aortic regurgitation, you may need to have surgery to repair or replace the valve. You will need to see your provider to have your situation evaluated and decide if you need surgery and if you are a candidate.

Being "a candidate; for surgery is a health provider's term to decide whether the benefits of a certain surgery could outweigh its risks for you. Several things, including tobacco use and poorly controlled underlying conditions, can increase your surgical risks or jeopardize healing. Your provider will discuss your risks and whether you can safely proceed with surgery.

Your doctor will probably recommend medicine to treat heart failure and enhance quality of life if you are not a candidate for valve surgery.

How do I prevent aortic regurgitation?

You can't always prevent heart valve disease. But you can lower your risk by:
Avoiding tobacco products and recreational drugs.
Getting the amount of exercise your healthcare provider recommends.
See a provider right away when you're sick or have an infection.
Make sure to take your drugs. This prescription includes drugs for high blood pressure.

What's my prognosis if I have aortic insufficiency?

Your prognosis depends on many factors. These include-

When you begin experiencing symptoms.
How advanced the condition is.
Whether heart failure has developed.
When you're treated.
Your overall health.

Studies suggest that individuals who undergo valve replacement surgery before they develop failure tend to have a good long-term outcome. Those who have already developed failure at the time of surgery may have a poorer outcome.

Discuss your prognosis with your doctor. Your physician knows you best and your medical history and, therefore, can give you some idea of what to expect based on that information.

Living With

How do I stay healthy?

Follow your healthcare provider's advice regarding self-care, including medications and lifestyle modifications. While the specifics of these recommendations will depend on your individual needs, in general, it is important to take all of your medications as directed and at the same time each day. Your provider also may recommend lifestyle changes, such as:

Eating a heart-healthy diet.
Regular exercise (inquire of your provider how much exercise and what types are safe for you).
Do not smoke or use any tobacco products (inquire of your provider for resources to help you quit)
Do not use recreational drugs, especially IV drugs, which increase your risk of endocarditis (heart valve infection).
Take good care of your gums and teeth to avoid endocarditis, which is an infection of the heart valves. This involves going to the dentist every six months.

Why Tender Palm Super-Speciality Hospital for Aortic Valve Regurgitation?

Tender Palm Hospital has the most experienced team of Cardiologists, Cardiac Surgeons, and diagnostics with the latest and International standard infection control measures in Lucknow, India. The Cardiac Science Centre team has decades of experience in successfully treating Aortic Valve Regurgitation.