Aortic Regurgitation (AR) is a condition that occurs when the aortic valve does not close properly. This allows some of the blood that was pumped out of your heart's main pumping chamber to leak back into it.
Typically occurs gradually over time.
May eventually lead to valve replacement surgery.
There are usually no symptoms until the valve leak is more severe, because aortic regurgitation usually advances slowly over years, giving the body time to adjust.
As it advances to severe, it can lead to lightheadedness or shortness of breath, resulting in decreased exercise tolerance.
The main pumping chamber of the heart, the left ventricle, can stretch over time to accommodate more blood, which leads to congestive heart failure and other complications, especially if left untreated.
In the U.S., aortic regurgitation most commonly develops over time due to a combination of age, high blood pressure, atherosclerosis, and aortic root dilation.
Dilation of the aorta is associated with genetic disorders like Marfan, Ehlers-Danlos, osteogenesis imperfecta, or with a family history of it.
Sometimes congenital, meaning due to a defect present at birth, such as a bicuspid aortic valve.
Radiation therapy (used to treat cancer) may be associated with valvular heart disease, if the cancer (and therefore the radiation beam) was located near the heart.
Rheumatoid arthritis, lupus, ankylosing spondylitis, and antiphospholipid syndrome are risk factors.
It can be caused by bacterial infections of the valve (endocarditis), though rare in the U.S.
Your healthcare provider may hear a murmur in your chest with their stethoscope. In aortic regurgitation, this murmur is caused by the sound of blood falling or leaking back into the heart through the leaky aortic valve. Other tests may include:
ECG – measures the electrical activity of the heart, regularity of heartbeats, and screens for thickening of the heart muscle (hypertrophy) and/or heart-muscle damage.
Echocardiogram – painless, noninvasive study that uses ultrasound waves to evaluate heart structure & function, including the heart valves, in real time.
Cardiac catheterization - threading a small tube (catheter) up a blood vessel into the heart chambers to measure pressures across the valve and to inject dye during a moving X-ray to detect/measure the regurgitation.
Control blood pressure, as high pressure increases wear and tear on the valve over time.
Mild to moderate aortic regurgitation is followed with a “watch and wait” approach, with a visit and/or echo every 1-2 years.
For severe aortic regurgitation, surgery to replace a damaged aortic valve may be necessary, especially once symptoms develop. The type of replacement valve depends on the patient’s age, condition, and their specific anatomy.
Most replacement valves nowadays are made from animal tissue (bioprosthetic valves).
Some may be made from metal (mechanical valves).
Valve can be replaced via open heart surgery, or less invasive procedure called TAVR is being used much more frequently now.
Most replacement valves nowadays are made from animal tissue (bioprosthetic valves). Some may be made from metal (mechanical valves). The type of replacement valve selected depends on the patient’s age, condition, and their specific anatomy.
The damaged valve can be replaced via open heart surgery. Though a newer, much less invasive procedure called TAVR is available now.
Patients do not need antibiotics for dental visits for aortic regurgitation, unless it was due to prior endocarditis (infection in the heart) or surgery was performed on the aortic valve.
