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Aortic valve regurgitation - aortic regurgitation - aortic insufficiency or aortic incompetence
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Aortic valve regurgitation - aortic regurgitation - aortic insufficiency or aortic incompetence
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Heart Disease

Screening and diagnosis

Identifying aortic regurgitation early is important because the condition can worsen with time and you may need surgery to correct it.

Your physician may first suspect that you have aortic regurgitation during a routine office visit after listening to your heart with a stethoscope and hearing an abnormal heart sound (heart murmur). Blood leaking through the aortic valve makes a distinct sound.

To begin the evaluation of your heart, your doctor will talk with you and ask questions about your health, including signs and symptoms, prior tests and history of heart disease in your family. Next your doctor will perform a physical examination that concentrates on your heart.

From this information, your doctor decides what tests you may need in order to make a diagnosis and a treatment plan. For testing you may be referred to a cardiologist — a doctor who specializes in the study of the heart and its function.

Other heart problems can cause signs and symptoms similar to those of aortic regurgitation, and it's possible to have more than one disorder at the same time. Common tests doctors use to diagnose aortic regurgitation include:

  • Chest X-ray. With an X-ray of your chest, your doctor can study the size and shape of your heart to determine whether your left ventricle is enlarged — a possible sign of damage to the aortic valve. 

  • Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart. Impulses are recorded as waves displayed on a monitor or printed on paper. An ECG can provide clues about whether the left ventricle is enlarged, a problem which can occur with aortic regurgitation.

  • Echocardiogram. This test uses sound waves to produce an image of your heart. In an echocardiogram, sound waves are directed at your heart from a wand-like device (transducer) held on your chest. The sound waves bounce off of your heart and are reflected back through your chest wall and processed electronically to provide video images of your heart. An echocardiogram helps your doctor get a close look at your aortic valve. A specific type of echocardiogram, a Doppler echocardiogram, may be used. It allows measurements of the volume of blood flowing backward through an aortic valve. This volume is expressed in cubic centimeters (cc) per beat.

  • Transesophageal echocardiogram. This type of echocardiogram allows an even closer look at your aortic valve. The esophagus, the tube that runs from your throat to your stomach, lies close to your heart. In a traditional echocardiogram, a transducer is moved across your chest to produce the sound waves necessary to create the image of your beating heart. In a transesophageal echocardiogram, a small transducer attached to the end of a tube is inserted down the esophagus. Because the esophagus lies close to your heart, having the transducer there provides a clear picture of your aortic valve and blood flow through it.

  • Exercise tests. Different types of exercise tests help measure your tolerance for activity and check your heart's response to exertion (exercise).

  • Cardiac catheterization. In this procedure, a doctor threads a thin tube (catheter) through a blood vessel in your arm or groin, into your heart. The catheter is used to deliver dye into your heart chambers and the blood vessels of your heart. The dye, appearing on X-ray images as it moves through your heart, gives your doctors detailed information about your heart and heart valves. Specifically, it can show if blood is leaking back from the aorta into the heart's left ventricle. Some catheters used in cardiac catheterization have miniature devices (sensors) at the tips that can measure pressure within heart chambers, such as the left ventricle. Pressure may be increased in the left ventricle with aortic regurgitation.

These tests help your doctors diagnose aortic regurgitation, determine how serious the problem is, and decide whether your aortic valve needs repair or replacement.


Aortic regurgitation — or any heart valve problem — puts you at risk of endocarditis. Endocarditis is an infection of the heart's inner lining — the endocardium. This membrane lines the four chambers and four valves of your heart. Typically, this infection involves one of the heart valves, especially if it's already damaged. If the aortic valve is leaky, it's more prone to infection than a healthy valve.

You can develop endocarditis when bacteria from another part of your body spread through your bloodstream and lodge in your heart. If you have aortic regurgitation, your doctor may recommend that you take antibiotics before certain dental or medical procedures to decrease the likelihood that bacteria will enter your bloodstream and cause an infection in your heart.

When it's mild, aortic regurgitation may never pose a serious threat to your health. But when it's severe, aortic regurgitation may lead to congestive heart failure. Congestive heart failure is a condition in which your heart is unable to pump sufficient blood to meet your body's needs. Congestive heart failure can be serious.


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