Definition

The aorta is the main artery carrying oxygen-rich blood from the heart to the body. After each heartbeat, the valve closes tightly to prevent blood from flowing backwards into the heart. Aortic insufficiency occurs when the aortic valve does not close tightly enough.

There are 2 types of aortic insufficiency:

• Acute aortic insufficiency —symptoms develop rapidly, and in severe cases, immediate surgery may be needed
• Chronic aortic insufficiency —symptoms develop over the course of many months or years

Aortic Valve Insufficiency

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Causes

Aortic insufficiency can be caused by:

• A birth defect of the aortic valve
• Severe high blood pressure
• Bacterial infection of the aortic valve
• Injury to the aortic valve
• Certain inflammatory diseases such as rheumatoid arthritis, lupus, temporal arteritis, and Reiter syndrome
• Aortic aneurysm
• Certain genetic conditions such as brittle bone disease, Marfan syndrome, Ehlers-Danlos syndrome, and cystic fibrosis
• Heart abnormalities such as a septal defect

Sometimes the cause of aortic insufficiency is unknown.

Risk Factors

Factors that may increase your chances of aortic insufficiency include:

• Family history of aortic insufficiency
• High blood pressure
• Use of drugs such as weight loss and appetite suppressant medications

Symptoms

Symptoms of aortic insufficiency include:

• Shortness of breath with activity
• Exercise intolerance
• Light-headedness
• Chest pain
• Heart palpitations
• Irregular heartbeat—arrhythmia
• Fainting
• Difficulty breathing when lying flat

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be taken of your heart. This can be done with:

• Chest x-ray
• MRI scan
• CT scan
• Echocardiogram
• Transesophageal echocardiogram (TEE)
• electrocardiogram (ECG)
• Cardiac catheterization

Treatment

Treatment options depend on the severity and history of the valve leakage. It also depends on the effects on the heart’s size and function. Talk with your doctor about the best treatment plan for you.

In chronic and slowly progressive aortic insufficiency, treatment may involve taking medicine. Surgery is needed in severe cases.

Depending on your condition, your doctor may schedule routine physical exams and echocardiograms.

Prevention

Aortic insufficiency may not be preventable. If you have a family history, talk with your doctor about screening tests.