- Define aortic valve regurgitation
From the hearts lower chamber into the aorta to the body the aortic valve allows the blood to flow. In order to keep the blood from flowing backward into the heart the valve closes and the heart rests between beats. In case of aortic valve regurgitation, due to the problem with the aortic valve, it doesn’t close as it should. Hence into the left ventricle the blood leaks back. Due to less blood supply the heart has to work harder.
In case of chronic aortic valve regurgitation the symptoms are :
- Most often when the person is active, there is shortness of breathe
- Fatigue or weakness
- Often by exercise angina may be caused, the heart has to put more effort.
In case of acute aortic valve regurgitation, the above symptoms are sudden and intense.
This condition can be caused by any other condition that damages the aortic valve. Common causes include:
- Infection of the heart called endocarditis
- Problem with artificial aortic valve
- If there is any trauma to the aorta or valve
- If the middle layer and inner layer of the aorta have separated
Through a stethoscope if the doctor hears a heart murmur then the doctor may suspect that there is some problem with valve. The doctor will ask about family history of heart disease, your past health and your symptoms. To confirm the diagnosis the doctor may suggest further tests like an echocardiogram. This will show whether the left ventricle is working properly and will show how much the valve is leaking.
Treatment depends on the symptoms and the factor responsible for the condition. Valve replacement surgery may be needed right away if you have aortic valve regurgitation and it is acute. The doctor may advice the following:
- Be away from second hand smoke and quit smoking
- Follow a diet that will keep your heart healthy
- Avoid activity that is intense but be active. Discuss with the doctor about the type of exercise safe for you.
- If needed lose weight.
- When to visit the doctor
Gradually if you notice that your symptoms are becoming worse than visit your doctor soon. A medicine change or a surgery may be needed. If any of the following occur then seek medical help right away:
- Symptoms of acute aortic valve regurgitation that is acute. These include rapid heartbeat, severe light headedness, chest pain, shortness of breath, loss of consciousness.
- Sudden new symptoms if you notice
- Risk factors
The following may increase the risk:
- Born with unicuspid or bicuspid flaps that are congenital defects rather than with three flaps.
- Increased age
- More prevalent in males
- Other medical conditions such as high blood pressure, Marfan’s syndrome and autoimmune diseases
- If you have a family history of congenital aortic defect, then this may also increase the risk hence inform your doctor.
- Valve replacement surgery
- Heart failure
- Sudden cardiac death
- The heart valves may get infected by bacteria
- Heart attack or stroke can be caused by blood clots
- Classification of aortic valve regurgitation
They are of two types:
- Acute aortic regurgitation- in left atrial pressure there is an acute rise that causes pulmonary edema. It may also cause cardiogenic shock. It is a medical emergency.
- Chronic aortic regurgitation- for many decades the patients may remain asymptomatic.
Due to their haemodynamic instability, the prognosis may be poor without intervention. If the condition is chronic then the prognosis is poor and long term. Without surgical treatment, mortality can be as high as 10-20 percent once the symptoms become apparent. In patients with ascending aortic and root aneurysms, the strongest predictors of death or aortic complications are the root diameter and a family history of acute cardiovascular events.