Aortic regurgitation
What is aortic regurgitation?
Aortic regurgitation is when the aortic valve doesn’t fully close, allowing some blood flow back into the heart. This can cause the chamber to get larger and its walls to thicken, eventually weakening the heart.
Causes
Most cases of aortic regurgitation develop slowly as a result of aging. But it can also occur because of an abnormality with the valve. Causes that contribute include:
Heart defects (e.g. bicuspid aortic valve, enlarged aorta)
Rheumatic fever
Rare conditions (e.g. Marfan syndrome, lupus)
Traumatic chest injury
Symptoms
Symptoms may be difficult to recognize, as they vary and are often dismissed as general signs of aging. Common symptoms include:
Shortness of breath or fatigue
Chest pain
Irregular heartbeat
Make sure you monitor any changes using a symptom tracker and attend regular checkups with your healthcare provider.
Treatments
If your valve requires treatment, a range of options may be available. Your heart team should carefully explain the risks and benefits of each approach for you. Together, you and your heart team can make the best decision about the right treatment for you. Treatment options may include:
Aorta repair
If aortic regurgitation is caused by an enlarged aorta rather than a faulty valve, surgically repairing the aorta can restore the valve to a properly functioning seal.
Aortic valve repair
With specific surgical repair techniques.
Surgical aortic valve replacement (SAVR)
A surgical valve replacement is usually performed by open heart surgery or, if possible, minimally invasive surgery with smaller incisions. The surgeon removes the aortic valve and replaces it with either a mechanical valve or a tissue valve, which is sometimes called a bioprosthetic or biological valve.
When deciding which valve is right for you, here are some factors to consider:
Mechanical valves are made of carbon or metal and are very durable – they can last a lifetime. This means it is less likely that you will need a second valve replacement.
With a mechanical valve, you will need to take blood-thinning medications every day for the rest of your life, to reduce the risk of blood clots forming in the valve.
Blood thinners increase your risk of bleeding which is important if some of your daily activities, such as your job or hobbies, increase your risk of falls, bumps or bruises.
Mechanical valves may make a clicking sound that you may be able to hear.
Bioprosthetic valve replacements are made of animal tissue that is strong and flexible enough to last 10-20 years.
They usually don’t require high doses of long-term blood-thinning medications which means your risk of bleeding is lower.
There is a higher chance you may need another operation with a bioprosthetic valve.
Lifestyle changes
With all heart valve diseases, healthy habits can improve your health generally and reduce the strain on your heart from everyday activities. Maintaining a healthy weight, stopping smoking, and starting light exercise like walking can help your heart adapt to work better despite valve disease.
Medical management
Regular checkups to monitor your heart health.
Your heart team may prescribe medications to relieve your symptoms, reduce complications and/or manage risk factors. Medicines are not a cure for heart valve disease.
There is a lot to consider when deciding on treatment. These resources will help you ask the right questions and participate in decision making with your heart team.
Patient Stories
If you have been diagnosed with aortic regurgitation, you are not alone. Learn from people who share their experience — and what they learned about diagnosis, treatment and recovery.
Frequently asked questions
How will I know if my valve disease is getting worse?
Symptoms that indicate your valve disease is getting worse may not happen for years after you are diagnosed with a valve problem. The most common symptoms include feeling more tired than usual or getting short of breath during routine activities. You may experience swelling of your ankles and feet. You may also feel dizzy.
Often times, symptoms start to occur very gradually and, therefore, it’s a good idea to keep track and write them down when they occur. Tracking your symptoms is tracking your health! Use our downloadable and printable Symptom Tracker to capture your symptoms on a daily basis and bring your Symptom Tracker for all of your appointments with your health care provider so that together, you can make appropriate decisions about your care. If you start experiencing any of the symptoms above, see your doctor.
Send us your questions and we will try to answer as many as we can in upcoming editions of this newsletter.
What are the risk factors for aortic regurgitation?
Risk factors for aortic regurgitation include general wear due to aging, congenital heart defects, genetic conditions like Marfan syndrome, kidney disease, diabetes, high blood pressure, high cholesterol, and previous infections present in the heart. It's important to tell your healthcare practitioner if any of these risk factors apply to you.
Is heart valve disease genetic?
Some types of heart valve disease can be inherited. The most common is bicuspid aortic valve however, most forms of heart valve disease have more to do with natural aging and lifestyle than with your genes.
If one of your parents or other close family members has valve disease, it is important to share that information with your primary healthcare provider.
If I have no symptoms, does that mean my heart valve disease is mild?
No. You can have severe valve disease and feel fine. That’s why it is important to have a healthcare provider to assess your heart regularly.
Resources
Initial Consultation Guide
This guide will help you prepare for an appointment with your doctor and support an efficient, informative, and helpful consultation. It outlines the types of questions your doctor may ask you during the consultation, as well as questions you'll want to consider asking.
Shared decision making
People diagnosed with heart valve disease are often confronted with a wide range of treatment options. Shared decision-making involves doctors and patients working together to choose the most suitable treatment, based on the patient’s preferences and goals as well as clinical evidence and the care team’s expertise. These resources aim to support people with heart valve disease in participating in decision-making about their care.
Get the shared-decision making guide
Symptom Tracker
Our symptom tracker has been developed to help people who think they may have heart valve disease, or other cardiac conditions, prior to or during consultation periods with their doctor. It captures symptoms to help you and your doctor understand your health and assist with diagnosis and ongoing care planning.
There is life after treatment.
Each person’s path to recovery will look different. Your treatment plan will be unique to your needs, and likewise, your recovery — the time it takes to return to a normal activity level and adapt to lifestyle changes — may vary from what others experience. Taking time to recover, both physically and mentally, is an important part of your journey.