Navigate Up

Neurology Center - A-Z Index

#
J
Q
X
Y
Z

Print This Page

Aortic insufficiency

Aortic insufficiency is a heart valve disease in which the aortic valve does not close tightly. This allows blood to flow from the aorta (the largest blood vessel) into the left ventricle (a chamber of the heart).

Alternative Names

Aortic valve prolapse; Aortic regurgitation

Causes

Any condition that prevents the aortic valve from closing completely can cause this problem. When the valve doesn't close all the way, a small amount of blood comes back each time the heart beats.

This makes the heart have to work harder to force out enough blood. The left lower chamber of the heart widens (dilates) and the heart beats very strongly (bounding pulse ). Over time, the heart becomes less able to supply enough blood to the body.

In the past, rheumatic fever was the main cause of aortic insufficiency. The use of antibiotics to treat strep infections has made rheumatic fever less common. Therefore, aortic insufficiency is more commonly due to other causes. These include:

Aortic insufficiency is most common in men between the ages of 30 and 60.

Symptoms

The condition often has no symptoms for many years. Symptoms may come on slowly or suddenly. They can include:

Exams and Tests

Signs may include:

  • Heart murmur that can be heard through a stethoscope
  • Very forceful beating of the heart
  • Bobbing of the head in time with the heartbeat
  • Hard pulses in the arms and legs
  • Low diastolic blood pressure
  • Signs of fluid in the lungs

Aortic insufficiency may be seen on tests such as:

A chest x-ray may show swelling of the left lower heart chamber.

Lab tests cannot diagnose aortic insufficiency. However, they may help rule out other causes.

Treatment

You may not need treatment if you have no symptoms or only mild symptoms. However, you will need to see a health care provider for get regular echocardiograms.

If your blood pressure is high, you may need to take blood pressure medicines to help slow the worsening of aortic regurgitation.

ACE inhibitor drugs and diuretics (water pills) may be prescribed for more moderate or severe symptoms.

In the past, most patients with heart valve problems were given antibiotics before dental work or an invasive procedure, such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart. However, antibiotics are now used much less often.

You may need to limit activity that requires more work from your heart. Talk to your health care provider.

Surgery to repair or replace the aortic valve corrects aortic insufficiency. The decision to have aortic valve replacement depends on your symptoms and the condition and function of your heart.

You may also need surgery to repair the aorta if it is widened.

Outlook (Prognosis)

Surgery can cure aortic insufficiency and relieve symptoms, unless you develop heart failure or other complications. People with angina or congestive heart failure due to aortic insufficiency do poorly without treatment.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of aortic insufficiency.
  • You have aortic insufficiency and your symptoms worsen or new symptoms develop (especially chest pain, difficulty breathing , or swelling )

Prevention

Blood pressure control is very important if you are at risk for aortic regurgitation.

References

Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2014;148(1):e1-e132.

Carabellow BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 75.

Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. St. Louis, MO: WB Saunders; 2011:chap 66.

Updated: 5/13/2014

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com