AORTIC INSUFFICIENCY

AORTIC INSUFFICIENCY

The aorta is the large artery that leaves the heart from the leftlower chamber (ventricle). The aortic valve is between the left ventricle and the aorta. Aortic insuffi ciency (or aortic regurgitation) is the leaking of blood from the aorta through the aortic valve into the left ventricle when the ventricle contracts. Aortic insuffi ciency causes the left ventricle to get larger because of the extra blood in it.

cause
The cause is a defective aortic valve or enlarged bottom part of the aorta. Infections such as rheumatic fever (usually from streptococcal infections) and endocarditis (bacterial infection in the heart) affect the valve. Congenital abnormalities such as bicuspid valve (two valve sections instead of three) are a common cause. Direct blunt injury (e.g., the chest hitting a steering wheel in an accident), connective tissue disorders such as Marfan’s disease, and hypertension can also lead to an enlarged aorta and subsequent aortic insuffi ciency.

symptom
Most people have no symptoms in early stages. Symptoms when present are tiredness, chest pain, diffi culty breathing (especially when lying down), coughing, and shortness of breath.

diagnosis
The doctor makes a diagnosis from a physical examination. Blood fl owing through the valve creates a heart murmur (extra or unusual sound during the heartbeat) that the doctor hears
with the stethoscope. The doctor will recommend echocardiography (a test that uses ultrasound waves to give a picture of the heart) to confi rm the diagnosis. For severe insuffi ciency with effects on the heart’s function, the doctor may suggest cardiac catheterization. In catheterization a small tube (catheter) is inserted into a leg artery and passed into the heart to get pictures of the heart and determine the severity of the aortic insuffi ciency.

treatment

For people without symptoms, the doctor may recommend regular check-ups including echocardiograms. If testing shows worsening aortic insuffi ciency and/or an enlarged heart, the
doctor may suggest seeing a thoracic surgeon (a specialist who performs heart valve operations) to correct or replace the valve. People with symptoms may also need medicines to prevent fl uid and pressure from building up in the heart. The doctor may also recommend referral to a thoracic surgeon in anticipation of future need for surgery.

Things to do

Do remember that you may not have symptoms but may
need to be checked with echocardiograms to follow the
valve disease.

Do take antibiotics (if prescribed) before dental or surgical
procedures if you had infectious endocarditis or prior
heart surgery.

Do ask your doctor for referral to a cardiologist (a doctor
who specializes in heart diseases) if you are having
symptoms.

Docall your doctor if you get shortness of breath, chest
or upper back pain, palpitations or rapid heartbeat, or
fainting.



don't do

DON’T do strenuous exercise if you have severe insuffi
ciency.

DON’T forget that periodic checkups to monitor for
aortic insuffi ciency and its effect on the heart are important