Aortic Valve Disease

Aortic Regurgitation

Enlarge

Symptoms

In most cases, aortic regurgitation develops gradually over decades. The heart compensates for the problem. No signs or symptoms may appear for many years. Most people are unaware they have this condition.

However, as aortic regurgitation progresses, signs and symptoms usually appear and may include:

• Fatigue and weakness, especially during physical exertion
• Shortness of breath, especially with physical exertion or when lying down
• Chest pain, discomfort or tightness, often increasing during physical exertion
• Fainting
• Rapid or irregular pulse
• Fluttering heart beat
• Swollen ankles and feet

Aortic valve regurgitation that occurs suddenly is a medical emergency that requires in-hospital treatment by one or more specialists.

Causes

Any condition that damages the aortic valve can cause regurgitation. Causes of aortic regurgitation may be:

Rheumatic fever
This complication of strep throat was once a common childhood illness in the United States. It can damage the aortic valve, leading to aortic regurgitation later in life, and may damage more than one heart valve and in more than one way. A damaged heart valve may not open fully or close fully — or both. Many older adults in the United States were exposed to rheumatic fever as children. Rheumatic fever is still prevalent in underdeveloped countries.

Deterioration of the valve with age
The aortic valve opens and shuts tens of thousands of times a day, every day of a person's life. Aortic regurgitation may result from age-related wear and tear on the valve. Mayo Clinic has extensive experience successfully treating elderly patients who have aortic regurgitation.

Endocarditis
The aortic valve may be damaged by endocarditis — an infection inside the heart that can involve the heart valves. Read more about endocarditis prevention.

Congenital heart defect
Some infants are born with an aortic valve that has one leaflet (unicuspid valve) or two leaflets (bicuspid valve) rather than the normal three leaflets. This puts the child at risk of developing aortic regurgitation at some point in their life.

Other causes
Other, rarer conditions can damage the aortic valve and lead to aortic regurgitation, including:

• Marfan syndrome, a disease of connective tissue
• Ankylosing spondylitis, a spine disorder
• Reactive arthritis, a rare form of arthritis affecting the eyes and joints
• Syphilis, a sexually transmitted disease
• Damage to the aorta near the aortic valve, such as damage from trauma to the chest or a tear in the aorta, can cause regurgitation