What is Aortic Valve Regurgitation?
What is Aortic Valve Regurgitation?Aortic valve regurgitation is a disorder in which the aortic valve in the heart does not close properly, allowing some blood to leak backward into the heart. The blood leaks into the pumping chamber, the left ventricle. The aortic heart valve regulates blood flow between the left ventricle and the aorta, the main artery that carries oxygenated blood from the heart to the rest of the body.
When the aortic valve leaks, the heart must work harder and may become less effective at pumping enough blood to supply the body with the oxygen it needs. This can result in shortness of breath and fatigue. This condition is also known as aortic regurgitation or aortic insufficiency.
Grades of Aortic Valve Regurgitation
GradesA grading system is commonly used to describe the severity of aortic valve regurgitation. The different grades are determined using a regurgitant fraction, representing the amount of blood backflowing into the pumping chamber.
- Grade 1 - Mild aortic regurgitation - The regurgitant fraction is less than 30%
- Grade 2 - Mild-to-moderate aortic regurgitation - The regurgitant fraction is 30-39%
- Grade 3 - Moderate-to-severe aortic regurgitation - The regurgitant fraction is 40-49%
- Grade 4 - Severe aortic regurgitation - The regurgitant fraction is 50% or higher
Signs & Symptoms of Aortic Valve Regurgitation
SymptomsSymptoms of aortic valve regurgitation can appear suddenly or gradually over time. Aortic valve regurgitation doesn’t always produce obvious symptoms, so the condition can go unnoticed for years. As it progresses, the signs and symptoms of aortic valve regurgitation may include:
- Shortness of breath
- Chest pain or tightness in the chest that worsens during physical activity
- Fatigue
- Fainting or lightheadedness
- Arrhythmias (irregular heart rhythms)
- Heart palpitations, including rapid, fluttering, or pounding heartbeat
- Swollen feet, ankles, and legs
If you are experiencing aortic valve regurgitation symptoms, contact a doctor immediately. In some cases of aortic valve regurgitation, the first symptoms that a person experiences are related to heart failure, such as persistent symptoms of fatigue, swelling in the legs and feet, or shortness of breath.
What Causes Aortic Valve Regurgitation?
CausesThe heart has four chambers: two upper chambers called atria and two lower chambers called ventricles. Heart valves have flaps that open and close as the heart beats to allow a certain amount of blood to flow from one chamber to the next while preventing blood from flowing backward.
The aortic valve is one of four valves in the heart. It regulates blood flow between the left ventricle and the aorta. The aorta is the main artery that carries oxygenated blood from the heart to the rest of the body. Aortic valve regurgitation occurs when the aortic valve does not close properly. This means that blood can leak back into the left ventricle, resulting in improper blood flow to the rest of the body.
Aortic valve regurgitation can be caused by:
- Congenital heart defects. Structural defects present from birth that prevent the aortic valve from closing properly. A normal aortic valve has three flaps that regulate blood flow, but some people are born with unicuspid aortic valves (only one flap), bicuspid (two flaps), or less commonly, quadricuspid (four flaps). These structural defects increase the risk of aortic valve regurgitation.
- Aortic valve stenosis. This condition causes the narrowing of the aortic valve, which prevents the valve from opening and closing as it should.
- Rheumatic fever. An inflammatory condition that results when strep throat or scarlet fever is not properly treated. It can damage parts of the heart and valves, causing the aortic valve to stiffen or narrow, resulting in a leak.
- Endocarditis. The endocardium is the tissue that lines the inside of the heart’s chambers and valves. Endocarditis is inflammation of the endocardium. The inflammation can result in damage that leads to aortic valve regurgitation. Endocarditis is frequently caused by an infection of the heart valve.
- Certain medical conditions cause the aorta and the aortic valve to enlarge, such as Marfan syndrome, lupus, Ehlers-Danlos syndrome, syphilis, and certain types of arthritis.
- Trauma. Including traumatic chest injuries that cause the aorta to tear.
Risk Factors for Aortic Valve Regurgitation
Risk FactorsSome characteristics and underlying conditions can put you at a higher risk of developing aortic valve stenosis than others. These risk factors include:
- Older age
- Chronic kidney disease
- History of infections affecting the heart
- High blood pressure
- High cholesterol
Complications
ComplicationsWhen left untreated, aortic valve regurgitation can result in complications such as:
- Heart failure. With aortic valve regurgitation, the heart has to work harder to pump blood around the body. Over time, this weakens the heart, and if left untreated, it can lead to heart failure.
- Infections of the heart, such as bacterial infections or endocarditis. The likelihood of infection increases with aortic valve regurgitation, especially following valve replacement surgery.
- Heart arrhythmias. Arrhythmias are irregular or abnormal heart rhythms caused by malfunctioning electrical signals. Aortic valve regurgitation can increase pressure in the heart and weaken the heart over time, increasing the risk of an arrhythmia.
- Sudden cardiac death. If aortic valve regurgitation is severe and sudden or left untreated for long periods of time, there is a chance of death.
Prevention
PreventionThere is no way to prevent aortic valve regurgitation entirely, but certain preventative measures can be taken to reduce the risk. Preventative measures of aortic valve regurgitation include:
- Maintaining a heart-healthy lifestyle. This includes regular exercise, maintaining a healthy weight, and eating a diet rich in whole grains, lean proteins, fruit, and vegetables. Avoid smoking, foods with high levels of saturated or trans fats, and foods with high salt content.
- Seeking immediate treatment for strep throat. Strep throat needs to be treated properly with antibiotics so that it does not progress into rheumatic fever, which can cause aortic valve regurgitation.
- Checking blood pressure regularly. Make sure your blood pressure stays in a healthy range to help avoid aortic valve regurgitation. If necessary, take medications as prescribed by your doctor to help control your blood pressure.
- Scheduling regular check-ups with your doctor to monitor heart activity, especially if you have a heart condition or if someone in your family has a valve defect, such as a bicuspid aortic valve. Aortic valve regurgitation or a different heart condition will be easier to treat when diagnosed in its earlier stages.
Trust NewYork-Presbyterian for Aortic Valve Regurgitation Care
NewYork-Presbyterian’s medical experts are highly skilled in treating aortic valve regurgitation and can provide personalized care services based on each patient’s needs. We also provide treatment for aortic valve stenosis, tricuspid valve disease, and mitral valve regurgitation.
Contact us today to make an appointment with one of our specialists.