Aortic Regurgitation

Reviewed/Revised Jan 2023
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What is aortic regurgitation?

The aorta is the main artery that carries blood away from your heart to the rest of your body.

Four heart valves control how blood flows in and out of your heart. The valves are like one-way doors that keep blood flowing in the right direction. 

The aortic valve separates your heart from the aorta. This valve opens into the aorta to let blood out of your heart. The valve closes to keep blood from running back into your heart.

Aortic regurgitation is a leak in your aortic valve. Because of the leak, some of the blood pumped out of your heart flows back into your heart each time the left ventricle relaxes.

  • Aortic regurgitation happens because of problems with your aortic valve, such as a birth defect or infection

  • The more blood that leaks backward, the harder your heart has to work to pump out enough blood

  • Eventually, your heart has to pump so hard to compensate for the leak that you develop heart failure

  • Doctors do echocardiography to diagnose aortic regurgitation

  • If regurgitation is severe, your aortic valve will need to be repaired or replaced

(See also Overview of Heart Valve Disorders.)

What causes aortic regurgitation?

Aortic regurgitation can develop suddenly or gradually.

Causes of sudden aortic regurgitation include:

Causes of gradual aortic regurgitation include:

  • Weakening of your valve or the first part of your aorta, such as from a birth defect

  • Untreated rheumatic fever

What are the symptoms of aortic regurgitation?

Mild aortic regurgitation may not cause symptoms.

Severe aortic regurgitation causes symptoms of heart failure, such as:

  • Shortness of breath when exercising

  • Problems breathing when lying flat

  • Chest pain, especially at night

  • A dip in blood pressure

How can doctors tell if I have aortic regurgitation?

Doctors suspect aortic regurgitation by listening to your heart with a stethoscope. Doctors use echocardiography (an ultrasound of your heart) to find out how bad the leak in your aortic valve is.

If the echocardiography shows you might have aortic dissection, doctors often do a CT scan (computed tomography) or MRI (magnetic resonance imaging).

How do doctors treat aortic regurgitation?

Doctors may give you medicine to lower your blood pressure so there's less force pushing blood back into your heart. Aortic regurgitation often gets worse over time. Doctors will monitor your symptoms and repeat the echocardiography to decide when to do surgery. Your aortic valve should be surgically repaired or replaced before your heart muscle is damaged.

Doctors can replace the valve with:

  • A plastic, mechanical valve

  • A valve from a pig or cow heart (bioprosthetic valve)

If you get a mechanical valve, you'll need to take blood-thinning medicine for the rest of your life, but the valve may last several decades. If you get a bioprosthetic valve, you'll need to take the blood-thinning medicine for only a few months, but the valve will last only 10 to 12 years.

People with damaged or replaced valves sometimes need antibiotics to prevent heart valve infection, such as when they:

  • Get dental work

  • Have certain medical procedures

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