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 may prevent your heart from efficiently pumping blood 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. 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 years, and you may even be unaware that you have the condition.
However, as aortic valve regurgitation worsens, signs and symptoms may include:
Contact your doctor right away if signs and symptoms of aortic valve regurgitation develop. Sometimes the first indications of aortic valve regurgitation are those of its major complication, congestive heart failure. See your doctor if you have fatigue, shortness of breath, and swollen ankles and feet.
Any condition that damages a valve can cause regurgitation. Causes of aortic valve regurgitation include:
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 close 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.
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, possibly causing it to enlarge and thicken.
At first, left ventricle enlargement helps because it maintains adequate blood flow with more force. But eventually these changes weaken the left ventricle — and your heart overall.
Your doctor will ask about your and your family's medical history and give you a physical exam that includes listening to your heart with a stethoscope. Aortic valve regurgitation usually produces a heart murmur, the sound of blood leaking backward through the aortic valve.
Your doctor will then decide what tests are needed to make a diagnosis. For testing, you may be referred to a cardiologist.
Other heart problems can cause signs and symptoms similar to those of aortic valve regurgitation, and it's possible to have more than one disorder at once. Common tests doctors use to diagnose aortic valve regurgitation include:
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.
Any heart valve problem puts you at risk of an infection of the heart's inner lining (endocarditis). If the aortic valve is leaky, it's more prone to infection than is a healthy valve.
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.
For any heart condition, see your doctor regularly so he or she can monitor you and possibly catch aortic valve regurgitation before it develops or in the early stages, when it's more easily treatable. Also, be aware of conditions that contribute to developing aortic valve regurgitation, including:
To improve your quality of life, your doctor may recommend that you:
If you're a woman of childbearing age with aortic valve regurgitation, discuss pregnancy with your doctor before you become pregnant. Pregnancy causes your heart to work harder. How a heart with aortic valve regurgitation tolerates this extra work depends on the degree of leakage and how well your heart pumps. Throughout your pregnancy and after delivery, your cardiologist and obstetrician should monitor you.
Your risk of aortic valve regurgitation is greater if you've been affected by any of the following: