Aortic Valve Regurgitation - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Aortic valve regurgitation is the condition of the heart in which there is the backflow of blood from aorta to left ventricle through the aortic valve during diastole. This leads to the backward flow of blood pumped out of the ventricle. The ventricle is the main pumping chamber of the heart. This backflow or leakage of blood prevents blood supply to various parts of the body, and the person may feel tired and have shortness of breath.

What Are The Symptoms?

Aortic valve regurgitation may develop suddenly or gradually. The patient may sometimes have no signs or symptoms for many years. Sudden type of aortic valve regurgitation occurs more commonly due to valve infection.

The following signs and symptoms may be observed when aortic valve regurgitation worsens:

• Tiredness and weakness, especially when there is an increase in the activity level.

• Heart murmurs.

• Shortness of breath while exercising or while lying down.

• Arrhythmia: irregular pulse.

• Lightheadedness.

• Fainting.

• Angina: Chest pain.

• Discomfort or tightness in the chest often occurs during exercise.

• Heart palpitations.

• Swelling of ankles and feet.

How Is It Caused?

Following are the causes of aortic valve regurgitation:

• Congenital Heart Valve Disease: Children born with an aortic valve have two cusps or fused cusps instead of the usual three separate cusps. There are chances of even a single cusp or four cusps, but they are rare.

• Aortic Stenosis: In this, narrowing of the aortic valve happens mainly due to calcium deposits.

• Endocarditis: It is a condition characterized by inflammation of the lining of the chambers and valves of the heart. It mainly occurs due to infection and can be life-threatening in nature.

• Rheumatic Fever: Rheumatic fever occurs as a complication of the streptococcal throat. It can lead to stiffness and narrowing of the aortic valve, called stenosis, and ultimately causes leakage of blood. It is called rheumatic heart disease if a patient has an abnormal valve due to rheumatic fever.

• Other Conditions: Some rare conditions can lead to enlargement of the aorta and aortic valve and, thus, causing regurgitation, including Marfan syndrome. It is a connective tissue disorder. A few autoimmune conditions, like lupus, can also lead to aortic valve regurgitation.

• Tear or Injury of the Aorta: If a person faces traumatic chest injury or aorta tears (called dissection), the blood flow may be backward through the aortic valve.

Are There Any Risk Factors?

Yes, a few risk factors may lead to the development of aortic valve regurgitation.

They are as follows:

• Older adults.

• Congenital heart disease.

• History of infections that can affect the heart.

• Increased blood pressure.

• Certain diseases may affect the heart, like Marfan syndrome.

• Other conditions are related to a heart valve, like aortic valve stenosis.

Are There Any Complications?

Following are the possible complications of aortic valve regurgitation:

• Heart failure.

• Fainting.

• Lightheadedness.

• Infections affecting the heart, like endocarditis.

• Arrhythmias: The rhythm of the heart is affected.

• Death.

How Can It Be Diagnosed?

When you visit your physician, you will be asked about symptoms you are facing. Following that, a physical examination will be carried out. There can be the presence of an abnormal sound while listening to the patient's heart with a stethoscope. A cardiologist is a specialist who is trained to manage this condition.

The doctor may also ask following tests to confirm the diagnosis:

• Echocardiogram: This test utilizes sound waves to check the heart.

• Electrocardiogram (ECG or EKG): This test utilizes wires or electrodes attached to the pads of the skin, and these electrodes measure the heart's electrical activity.

• Chest X-ray: A chest X-ray is used to visualize any enlargement in the heart or aorta. It can also be utilized to assess the condition of the lungs.

• Exercise or Stress Tests: Exercise tests help the physician to assess the heart for the presence of any type of aortic disease while performing physical activity.

• Cardiac MRI: In MRI (magnetic resonance imaging), a magnetic field and radio waves are utilized to get a detailed picture of the heart, including the aorta and aortic valve.

• Cardiac Catheterization: This is not a routine test for the detection of aortic valve regurgitation and can be utilized in cases where all other tests cannot diagnose the condition.

How Can It Be Treated?

The management of aortic valve regurgitation depends on various factors like the presence of signs and symptoms, severity, and worsening of the condition. The main goals of aortic valve regurgitation management include easing the symptoms and preventing the development of any complications. Suppose the patient has mild symptoms or does not have any symptoms. In that case, the physician may go ahead with regular follow-ups to monitor the condition and advise regarding healthy life changes.

Following are the other two main treatment options available for aortic valve regurgitation:

1. Medications:

The physician may recommend some medications to manage the symptoms of aortic valve regurgitation or reduce the risk of developing any complications. Medications may also be prescribed to decrease blood pressure.

2. Surgery and Other Procedures:

Patients with severe aortic regurgitation or severe symptoms may require surgery to repair or replace the diseased aortic valve. Various factors that may affect the type of surgery are the severity and type of symptoms, age, general health, and whether the patient requires heart surgery to correct another heart problem or not.

Following are the surgeries that can be done:

• Aortic Valve Repair: The surgeons may separate the fused valve flaps, reshape or remove any excess valve tissue, or patch the holes in a valve.

• Aortic Valve Replacement: In this, the surgeon removes the damaged valve, and it is replaced with a mechanical valve or a valve made from pig, cow, or human heart tissue. Transcatheter aortic valve replacement (TAVR) is a minimally invasive heart procedure that helps replace a narrowed aortic valve using a biological tissue valve. Sometimes even the lung artery in the same person's lung may be used to correct this condition.

How Can It Be Prevented?

Following are the methods to prevent this condition:

• Have a regular checkup.

• In case of family history, get an echocardiogram test done.

• If you have strep throat, get it treated, as it may lead to rheumatic fever.

• Maintain your blood pressure to prevent aortic regurgitation.

Conclusion:

Aortic valve regurgitation is the condition of the heart in which there is the backflow of blood from aorta to left ventricle through the aortic valve during diastole. You can consult a specialist to know more about this condition through online medical platforms.