AORTIC REGURGITATION
Aortic regurgitation occurs when the valve is damaged in such a way that the opening cannot be closed completely by the valve leaflets, thus allowing blood to wash back into the left ventricle from where it came instead of the aorta where it should be going. To the extent that this is occurring, symptoms may be mild or severe. Rheumatic fever causes most cases, but other diseases may be causative as well (syphilis, ankylosing spondylitis).
Symptoms
Often ten or more years elapse after the acute rheumatic fever episode, after which a period of compensation and relatively stable symptoms occurs. Then, shortness of breath, and later angina occur similar to aortic stenosis, except for a more progressive and less precipitous course. These are discussed elsewhere in HealthNet, under heart failure and angina. A period of ten or more years is common between onset of symptoms and death, even if untreated.
Treatment
The same medications used for the other forms of valve disease discussed above may also be used for patients with aortic regurgitation, including digoxin, diuretics, rhythm stabilizing drugs and nitroglycerine for angina. These can often defer the need for surgery.
Once symptoms of heart failure ensue, surgical valve replacement is considered. Without this treatment, average survival is a matter of a few years; with surgery prolonged survival is common. As with other valvular disease, it is important not to wait too long for the operation, since irreversible damage to the heart musxle can dramatically increase the dangers of surgery.
General Comments
All damaged heart valves are susceptible to infection with germs that enter the blood stream; this occurs in all people normally, but is generally not dangerous. In cases of valve disease, it is possible for the heart to become infected in a serious or even life-threatening way.
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