Alternate Names: Aortic valve prolapse; Aortic regurgitation
Causes and Risks:
Aortic insufficiency is a heart valve disease where the aortic valve no longer functions adequately to control the flow of blood from the left ventricle into the aorta.
Aortic insufficiency can result from any condition that weakens the aortic valve. Rheumatic fever used to be the primary cause of aortic insufficiency. With antibiotic treatment of rheumatic fever, other causes are being seen with increasing frequency. These include congenital conditions, endocarditis, hypertension, Marfan’s syndrome, aortic dissection, ankylosing spondylitis, Reiter’s syndrome, syphilis, and other disorders.
The disorder affects approximately 5 out of 10,000 people. It is most common in men 30 to 60 years old.
Prevention:
Aortic insufficiency cannot be prevented but some of the complications can be.
Notify the health care provider or dentist about any history of heart valve disease before treatment for any condition. Any dental work, including cleaning, and any invasive procedure, can introduce bacteria into the bloodstream. This bacteria can infect a weakened valve causing endocarditis.
Follow the provider’s treatment recommended for conditions that may cause valve disease. Treat strep infections promptly to prevent rheumatic fever. Notify the provider if there is a family history of congenital heart diseases.
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)
- under the sternum, may radiate
- crushing, squeezing, pressure, tightness
- 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 and diastolic blood pressure) may be widened to more than 60, and diastolic blood pressure may be low. There may be signs of pulmonary edema.
Aortic insufficiency may be seen on:
An ECG test or Chest X-ray may show left ventricle enlargement.
Lab tests are nondiagnostic for aortic insufficiency, but may they be used to rule out other disorders or causative factors.
Treatment:
If no symptoms, or if symptoms are mild, the disorder may only require observation. If symptoms are severe, hospitalization may be required. Medications such as diuretics or digoxin may be used to stabilize the condition. These medications may also be used in people with mild symptoms to prevent the symptoms from worsening. Moderate activity restriction may be recommended.
Surgical repair or replacement of the aortic valve corrects aortic insufficiency. Surgical repair of the aorta may be required if insufficiency is caused by disorders of the aorta.
Prognosis: Aortic insufficiency is curable with surgical repair. The person may become symptom-free unless severe heart failure is present or other complications develop.
Complications:
Call for an appointment with your health care provider if symptoms indicate aortic insufficiency may be present.
Call your health care provider if symptoms worsen or new symptoms develop in a person with aortic insufficiency; especially chest pain, difficulty breathing, or edema (swelling).
