Aortic regurgitation

Alternative names

Aortic valve prolapse; Aortic insufficiency

Definition

Aortic insufficiency is a heart valve disease in which the aortic valve weakens or balloons, preventing the valve from closing tightly. This leads to backward flow of blood from the aorta (the largest blood vessel) into the left ventricle (the left lower chamber of the heart).

Causes, incidence, and risk factors

Aortic insufficiency can result from any condition that weakens the aortic valve. In the past, rheumatic fever was the primary cause of aortic insufficiency. Now that antibiotics are used to treat rheumatic fever, other causes are more commonly seen.

These include congenital conditions (abnormalities of the valve which are present at birth), endocarditis (valve infection), High blood pressure, Marfan's syndrome, aortic dissection (a tear in the lining of the aorta), Ankylosing spondylitis, Reiter's syndrome, Syphilis (now rare), and other disorders.

Aortic insufficiency affects approximately 5 out of every 10,000 people. It is most common in men between the ages of 30 and 60.

Symptoms

• marked, unpleasant sensation of heart beating (palpitations)
  
• pulse, bounding
  
• irregular, rapid, racing, pounding or fluttering pulse
  
• fainting
  
• weakness, particularly with activity
  
• Shortness of breath with activity or when lying down
  
• fatigue, excessive tiredness
  
• chest pain, angina type (rare)
  o under the sternum, may radiate
  o crushing, squeezing, pressure, tightness
  o pain increases with exercise, relieves with rest
  

Note: Commonly, aortic insufficiency shows no symptoms for many years. Symptoms may then occur gradually or suddenly.

Signs and tests

Auscultation (listening to the chest with a stethoscope) detects a heart murmur. Palpation (examination by hand) may show hyperdynamic (very forceful) beating of the heart. Pulse pressure (the difference between systolic blood pressure - the pressure during contraction of the heart - and diastolic blood pressure - the pressure during relaxation of the heart) may be widened, and diastolic blood pressure may be low. There may be signs of (fluid in the lungs).