Aortic valve regurgitation
Aortic valve regurgitation
Aortic valve regurgitation — or aortic regurgitation — is a condition that occurs when your heart's aortic valve doesn't close tightly. Aortic valve regurgitation allows some of the blood that was just pumped out of your heart's main pumping chamber (left ventricle) to leak back into it.
The leakage of blood may prevent your heart from efficiently pumping blood out to the rest of your body. As a result, you may feel fatigued and short of breath.
Aortic valve regurgitation can develop suddenly or over decades. Aortic valve regurgitation has a variety of causes, ranging from congenital heart defects to complications of infectious illnesses. Once aortic valve regurgitation becomes severe, surgery is often required to repair or replace the aortic valve.
Most often, aortic valve regurgitation develops gradually, and your heart compensates for the problem. You may have no signs or symptoms for many years, and you may even be unaware that you have this condition.
However, as aortic valve regurgitation gets worse, signs and symptoms usually appear and may include:
When to see a doctor
Aortic valve regurgitation disrupts the way blood normally flows through your heart and its valves.
Your heart, the center of your circulatory system, consists of four chambers. The two upper chambers, the atria, receive blood. The two lower chambers, the ventricles, pump blood to your lungs and to the rest of your body. Blood flows through your heart's chambers, aided by four heart valves.
The aortic valve consists of three tightly fitting, triangular flaps of tissues called leaflets. These leaflets connect to the aorta through a ring called the annulus.
Heart valves open like a one-way gate. The leaflets of the aortic valve are forced open as the left ventricle contracts and blood flows into the aorta. When the blood has gone through the valve and the left ventricle has relaxed, the leaflets swing closed to prevent the blood that has just passed into the aorta from flowing back into the left ventricle.
A defective heart valve is one that fails to either open or close fully. When a valve doesn't close tightly, blood can leak backward. This backward flow through a valve is called regurgitation.
Aortic valve regurgitation — of any cause — can weaken your heart. In aortic valve regurgitation, some blood leaks back into the left ventricle instead of flowing onward to the rest of your body after being pumped into the aorta. This forces the left ventricle to hold more blood. In response, this chamber of your heart may enlarge and thicken. At first, these adaptations help the left ventricle pump blood with more force. But eventually these changes weaken the left ventricle — and your heart overall.
Chambers and the valves of the heart
A normal heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood ...
Your risk of aortic regurgitation is greater if you've been affected by any of the following factors:
Aortic valve regurgitation — or any heart valve problem — puts you at risk of endocarditis. Endocarditis is an infection of the heart's inner lining — the endocardium. This membrane lines the four chambers and four valves of your heart. Typically, this infection involves one of the heart valves, especially if it's already damaged. If the aortic valve is leaky, it's more prone to infection than is a healthy valve. You can develop endocarditis when bacteria from another part of your body spread through your bloodstream and lodge in your heart.
When it's mild, aortic valve regurgitation may never cause a serious threat to your health. But when it's severe, aortic valve regurgitation may lead to heart failure. Heart failure is a serious condition in which your heart is unable to pump enough blood to meet your body's needs.
Preparing for your appointment
You're likely to start by first seeing your family doctor. After your initial appointment, your doctor may refer you to a doctor who specializes in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
Questions to ask your doctor at your initial appointment include:
Questions to ask if you are referred to a cardiologist include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
What you can do in the meantime
If exercise makes your symptoms worse, avoid intense physical activity until you've been seen by your doctor.
Tests and diagnosis
Identifying aortic valve regurgitation early is important because the condition can worsen with time, and you may need surgery to correct it.
Your doctor may first suspect that you have aortic valve regurgitation during a routine office visit after listening to your heart with a stethoscope and hearing an abnormal heart sound (heart murmur). Blood leaking through the aortic valve often makes a distinct sound.
To begin the evaluation of your heart, your doctor will ask you questions about your personal and family health history. Next your doctor will perform a physical examination that concentrates on your heart.
From this information, your doctor decides what tests you may need in order to make a diagnosis and develop a treatment plan. For testing, you may be referred to a cardiologist — a doctor who specializes in the study of the heart and its function.
These tests help your doctors diagnose aortic valve regurgitation, determine how serious the problem is, and decide whether your aortic valve needs repair or replacement.
Treatments and drugs
Treatment of aortic valve regurgitation depends on how severe your regurgitation is, your signs and symptoms, and whether the regurgitation is affecting your heart function. If you have aortic valve regurgitation, your doctor will evaluate your heart with regular echocardiograms to determine whether damage to your heart is getting worse.
The overall function of your heart and the amount of regurgitation help to determine when surgery is necessary. Surgical procedures include:
Aortic valve regurgitation can be eliminated with surgery, and you can usually resume normal activities within a few months. The prognosis following surgery is generally good.
Lifestyle and home remedies
To improve your quality of life if you have aortic valve regurgitation, your physician may — in addition to other treatments — recommend that you:
If you're a woman of childbearing age with aortic valve regurgitation, discuss pregnancy and family planning with your doctor because your heart works harder during pregnancy. How a heart with aortic valve regurgitation tolerates this extra work depends on the degree of leakage and how well your heart pumps. If you become pregnant, you'll need evaluation by your cardiologist and obstetrician throughout your pregnancy, labor and delivery, and after delivery.
Often, aortic valve regurgitation isn't a preventable condition, though there are steps you can take to protect your aortic valve from damage, including:
Last Updated: 2011-09-22
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