What is Aortic Valve Regurgitation?

Aortic valve regurgitation occurs when the aortic valve leaks each time the left ventricle relaxes. This allows blood to flow in two directions – out through the aorta to the body, but also backward from the aorta into the left ventricle when the ventricle relaxes.

To compensate for the aortic valve leak, the heart will have to work harder, sometimes causing the walls of the ventricle to thicken. A thickened heart muscle is less effective, and eventually the heart may be unable to pump enough blood to meet the body’s needs, leading to heart failure. 

Baptist Health is known for advanced, superior care for patients with heart problems and the diagnosis, treatment and management of aortic valve regurgitation. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health. 

Aortic Valve Regurgitation Signs and Symptoms

Aortic valve regurgitation may not cause symptoms for years. As the condition worsens, signs and symptoms may include:

• Arrhythmia (irregular rhythm)
• Chest pain, discomfort or tightness, especially during exercise
• Fatigue and weakness, especially with increased activity
• Heart murmur
• Lightheadedness or fainting
• Palpitations (rapid or fluttering heartbeat)
• Shortness of breath with exertion or when lying down
• Swollen ankles and feet

Aortic Valve Regurgitation Diagnosis

To diagnose aortic valve regurgitation, we ask questions about your medical history and do a physical exam. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:

Cardiac catheterization: A long, thin flexible tube is threaded through a blood vessel in the arm or groin and to the heart. Contrast material is injected through the tube and a type of X-ray video is taken to show how the heart functions and to look for heart blockages.

Magnetic resonance imaging (MRI):A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Chest X-ray: A common imaging test of the lungs, heart and aorta.

Computed tomographic angiography (CT): This non-invasive test can show the arteries in the abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Stress testing: This test is conducted during exercise. If a person can't exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise makes the heart work hard and beat fast while heart tests are administered.

Aortic Valve Regurgitation Causes

Aortic valve regurgitation can be caused by hypertension, which can stretch the root of the aorta where the aortic valve sits, causing the valve flaps to no longer meet and resulting in leakage.

Risk Factors

Risk factors that could contribute to aortic valve regurgitation include: 

Age: By middle age, a person may develop some aortic valve regurgitation caused by natural deterioration of the valve. 

Congenital heart valve disease: A person can be born with an aortic valve that has only two cusps (bicuspid valve) or fused cusps rather than the normal three separate cusps. This increases the risk of developing aortic valve regurgitation. 

Disease: Certain rare conditions can enlarge the aortic valve and lead to regurgitation, including Marfan syndrome, a connective tissue disease. 

Endocarditis: This infection of the heart’s inner lining typically occurs when bacteria from the mouth or elsewhere get into the bloodstream and lodge in the heart. It can damage the aorta. 

Rheumatic fever: Rare in the United States and other developed countries, rheumatic fever can occur without prompt or complete treatment of a strep throat infection – damaging the heart valves. 

Trauma: Damage to the aorta near the site of the aortic valve, from an injury to the chest or a tear in the aorta, also can cause backward flow of blood through the valve.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent an aortic valve regurgitation: 

Get enough exercise: Even moderate activity can make a big difference in heart health by helping you maintain a healthy weight and control blood pressure.

Stop smoking: Smoking can lead to high blood pressure and otherwise damage the heart.

Take medications as prescribed: If you’re on medications to lower blood pressure, continue taking them as directed.

Watch what you eat: Stick to a diet rich in fruit, vegetables and whole grains and low in fat, sugar and salt.

Aortic Valve Regurgitation Prognosis

Prognosis for aortic valve regurgitation depends on the severity of regurgitation, what symptoms are present and whether the regurgitation is affecting heart function.

Treatment and Recovery

Treatment for aortic valve regurgitation depends on the severity of the condition, and may include: 

Lifestyle Changes and Regular Monitoring

If aortic valve regurgitation is mild with little to no symptoms, you may be prescribed lifestyle changes and regular monitoring by a physician.

Minimally Invasive Procedures

Aortic valve replacement typically requires open-heart surgery. Less invasive surgical techniques and procedures, such as transcatheter aortic valve replacement (TAVR), are being explored as a treatment for aortic valve regurgitation. 

Surgery

Your physician may recommend surgery to treat aortic valve regurgitation. Options include:

• Valve repair: Aortic valve repair can preserve the valve and improve its function. Sometimes surgeons can modify the original valve to eliminate backward blood flow. 
• Valve replacement: Many times, the aortic valve has to be replaced with a mechanical valve or a tissue valve.

Recovery After Surgery

Depending on how your body heals, you will be in the hospital for four to six days and recover well within several months. Your physician will tell you when you may be physically active again and what activities to avoid. If you have had open heart surgery or serious symptoms resulting from aortic valve disease that have affected your heart health, your doctor may recommend a cardiac rehabilitation program. These programs provide an exercise regimen specifically designed to help you slowly strengthen your heart, and make other diet and lifestyle changes that will reduce your risk of heart attack, heart failure, and other complications.

Complications

Mild aortic valve regurgitation may not cause problems, but a severe case can lead to complications including:

Endocarditis: Any heart valve problem puts you at risk of an infection of the heart’s inner lining.

Heart failure: This occurs when the heart can’t pump enough blood to meet the body’s needs