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Aortic regurgitation is a heart defect that may be asymptomatic for many years, contributing to systematic impairment of heart function. The risk of aortic regurgitation is, among others, people with hypertension and atherosclerosis, as well as those who had syphilis. Find out what are the causes and symptoms of aortic regurgitation. What is the treatment of this type of defect? ​​

Aortic regurgitationisa heart defectinvolving the abnormal closure of aortic valve leaflets, causing blood to flow backward from the aorta to the left ventricle.

Aortic regurgitation - what is it?

The aortic valve(the aortic valve) is one of the two arterial valves located in the heart. Its function is to prevent the flow of blood from the aorta into the left ventricle.

A properly functioning aortic valve opens when the ventricles contract, allowing blood to flow from the left ventricle into the aorta, and then closes when it relaxes, preventing blood from flowing back. When the aortic valve does not close completely, more blood than needed accumulates in the left ventricle, overloading the ventricle and progressively impairing its function. The size of the heart also increases, which is then referred to as the buffalo heart.

Aortic regurgitation: acute and chronic

Taking into account the rate of development of aortic valve disease, regurgitation is divided into: acute and chronic.

We talk about chronic aortic regurgitation when the backflow of blood leads to an increase in the volume of the left ventricle and its volume overload and compensatory muscle hypertrophy. In this case, it does not always have to develop a set of characteristic symptoms. It is only with the passage of time, when the defect worsens and the heart gradually increases in size and the contractility of the left ventricle decreases, that the patient complains of respiratory and circulatory failure.

In turn, we speak of acute aortic regurgitation when blood flow disorders appear rapidly.

Read Also: What Heart Diseases May Develop Withage?

Aortic regurgitation - causes

  • Congenital - abnormal, non-trilobal valve damage to the valve leaflets in other congenital malformations.
  • Damage to the valve as a result of inflammatory changes in the course of: infective endocarditis or rheumatic fever, rheumatoid arthritis, ankylosing spondylitis.
  • Dilation or damage to the ascending aorta due to: hypertension, Marfan's syndrome, aortitis, aortic dissection, atherosclerosis, syphilis, trauma.

If the causes of regurgitation are unknown, it is called idiopathic regurgitation.

Aortic regurgitation - symptoms

Chronic aortic regurgitationis usually asymptomatic for many years. Fatigue is the most commonly reported symptom.

Acute aortic regurgitationthe most common symptoms are:

  • quickly developing shortness of breath
  • limited exercise tolerance
  • pain in aortic dissection
  • palpitations

There are also symptoms of the disease that led to regurgitation.

Sometimes there are also symptoms of transient cerebral ischemia, such as dizziness or temporary fainting.

It should be remembered that the course of acute aortic regurgitation depends on the underlying disease.

Important

The heart rate, known as the "ram pulse", is also specific. Strong pulsation of the carotid vessels can cause the head to tremble in sync with the heart rhythm.

Aortic regurgitation - diagnosis

The first stage of the diagnostic cycle is the stethoscope examination. The presence of a "puffing" (soft, high-pitched) diastolic murmur is suspected of aortic stenosis.

Changes in blood pressure are also characteristic. A large difference is then observed between the systolic and diastolic pressure, and the diastolic pressure may be practically undetectable. This difference is clearly felt, especially on the upper and lower limbs.

Then an electrocardiogram (EKG) is performed, which may show signs of left ventricular overload, and a chest X-ray image. In chronic regurgitation, the picture shows left ventricular enlargement and dilation of the ascending aorta and aortic arch.

The echocardiographic examination is decisive in the diagnosis and assessment of the severity of the defect. Echocardiography allows you to judge the degreethe advancement of the defect, left ventricular systolic activity, dimensions of the heart cavities and ascending aorta, and possible damage to the valve leaflets as a result of e.g. inflammation.

Aortic regurgitation - treatment

In the case of mild and moderate defect, when there are no clinical symptoms and normal heart function is maintained, no treatment is necessary. In other cases, two methods of treatment are used: conservative and invasive.

1. Conservative treatment

Conservative treatment is pharmacological treatment based on vasodilating drugs. The goal of this treatment is to reduce the feedback wave, so it can be used in people with severe chronic regurgitation (also with normal left ventricular function).

Conservative treatment is also used in people who, due to their severe general condition, cannot be qualified for surgery.

Pharmacological treatment is also used for the immediate normalization of blood circulation before the planned surgery.

Important

In people with aortic valve insufficiency, it is necessary to prevent the development of infective endocarditis by prophylactic use of antibiotics, especially before planned procedures (including dental procedures).

2. Invasive treatment

Invasive treatment involves surgical replacement of a damaged valve with an artificial valve. Often, simultaneous implantation of the ascending aorta is performed. Invasive treatment is used for acute aortic regurgitation, ascending aortic dilatation, and severe regurgitation.

The effectiveness of the treatment depends, inter alia, on the severity of the defect and the degree of severity of the heart failure. The perioperative mortality is around 3-8%.

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Category:

Cardiology