Aortic Regurgitation

Aortic regurgitation, also known as aortic insufficiency, is a condition where the aortic valve does not close properly, allowing blood to flow back from the aorta into the left ventricle of the heart.

Causes

The causes of aortic regurgitation can be divided into two main categories: acute and chronic. Acute aortic regurgitation is often caused by:

• Aortic dissection, where there is a tear in the inner layer of the aorta
• Endocarditis, an infection of the heart valves
• Trauma to the chest

Chronic aortic regurgitation can be caused by:

• Rheumatic heart disease, where the heart valves are damaged due to rheumatic fever
• Marfan syndrome, a genetic disorder that affects the connective tissue in the body
• Other conditions such as syphilis, ankylosing spondylitis, and systemic lupus erythematosus
• Aging and wear and tear on the valve

Symptoms

The symptoms of aortic regurgitation can vary depending on the severity of the condition. Common symptoms include:

• Shortness of breath, especially when lying down or exercising
• Chest pain or discomfort, often described as a feeling of pressure or tightness
• Palpitations or irregular heartbeat
• Fatigue and weakness
• Swollen legs, ankles, or feet due to fluid buildup

Diagnosis

Aortic regurgitation is typically diagnosed using a combination of physical examination, medical history, and diagnostic tests. These tests may include:

• Echocardiogram, an ultrasound test that uses sound waves to create images of the heart
• Chest X-ray, which can show enlargement of the left ventricle or aortic root
• Electrocardiogram (ECG), which measures the electrical activity of the heart
• Cardiac catheterization, where a small tube is inserted into an artery in the leg and guided to the heart to measure blood pressure and take blood samples

Treatment

The treatment for aortic regurgitation depends on the severity of the condition. Mild cases may not require treatment, while more severe cases may require:

• Medications to manage symptoms and slow disease progression, such as diuretics, ACE inhibitors, and beta blockers
• Surgery to repair or replace the aortic valve, which can be done using open-heart surgery or minimally invasive techniques
• Aortic valve replacement with a mechanical or bioprosthetic valve

Complications

If left untreated, aortic regurgitation can lead to complications such as:

• Heart failure, where the heart is unable to pump enough blood to meet the body's needs
• Atrial fibrillation, an irregular heartbeat that can increase the risk of stroke and other complications
• Endocarditis, an infection of the heart valves
• Sudden cardiac death, where the heart stops beating suddenly and unexpectedly

Prognosis

The prognosis for aortic regurgitation depends on the severity of the condition and how well it is managed. With proper treatment, many people with aortic regurgitation can lead active and normal lives. However, if left untreated, the condition can progress and lead to serious complications.