Aortic regurgitation
Peer reviewed by Dr Adrian Bonsall, MBBSLast updated by Dr Colin Tidy, MRCGPLast updated 1 Aug 2017
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In this series:Heart valve diseaseMitral stenosisMitral regurgitationAortic stenosisInfective endocarditis
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Aortic regurgitation is sometimes called aortic incompetence or a leaky aortic valve. In aortic regurgitation the valve does not close properly. The aortic valve is a heart valve that lies between the left ventricle and the aorta. Therefore, blood leaks back (regurgitates) into the left ventricle from the aorta.
In some cases, aortic regurgitation occurs at the same time as aortic stenosis. Read more about aortic stenosis.
At a glance
Aortic regurgitation is when the aortic valve in your heart does not close tightly.
Mild aortic regurgitation often causes no symptoms.
Symptoms can include tiredness, shortness of breath, and swollen ankles.
Treatment for aortic regurgitation may involve medication or surgery.
Surgical options include repairing or replacing the aortic valve.
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Symptoms
Mild aortic regurgitation may cause no symptoms. However symptoms may include
Shortness of breath, especially with exercise or when you lie down
Swollen ankles (oedema)
Treatment
Back to contentsIf the backflow of blood is mild then you may not need any treatment. If you develop complications, various medicines may be advised. Surgery may sometimes be advised.
Medication
Medication may be advised to help ease symptoms of heart failure if heart failure develops - for example, angiotensin-converting enzyme (ACE) inhibitors and/or 'water' tablets (diuretics). See separate leaflet called Heart Failure for more details on treatment methods.
Surgery
Surgical options include repair of the aortic valve or replacement of the valve. The most recent guideline recommends replacement as the preferred option in most cases.
Valve replacement surgery may be with a mechanical or a tissue valve. Mechanical valves are made of materials which are not likely to react with your body, such as titanium. Tissue valves are made from treated animal tissue, such as valves from a pig. If you need surgery, a surgeon will advise on which is the best option for your situation.
Surgical treatment has greatly improved the outlook in most people with more severe regurgitation. The outlook (prognosis) is good if the valve is treated before the heart becomes badly damaged.
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What is the outcome?
Back to contentsThe outcome (prognosis) will depend on the underlying cause and the severity of aortic regurgitation. The outcome is generally poor if there is no treatment but is good with available modern treatments.
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Frequently asked questions
Can aortic regurgitation always be treated effectively?
The outcome for aortic regurgitation is generally poor if left untreated. However, with modern treatments available, the prognosis is good. Surgical treatment has significantly improved the outlook for most people with more severe regurgitation, especially if the valve is treated before the heart suffers extensive damage.
What is the likelihood of needing surgery for aortic regurgitation?
If your aortic regurgitation is mild, you might not require any treatment. However, if complications develop, surgery may sometimes be advised. For more severe cases, surgical treatment has greatly improved the outlook.
What are the common symptoms I should look out for with aortic regurgitation?
You might experience tiredness, weakness, and shortness of breath, particularly during exercise or when lying down. Other symptoms can include lightheadedness or fainting, and swollen ankles (oedema). In some cases, mild aortic regurgitation may cause no symptoms at all.
Are there different types of valves used in replacement surgery?
Yes, valve replacement surgery can involve either a mechanical or a tissue valve. Mechanical valves are typically made from materials like titanium, designed not to react with your body. Tissue valves are derived from treated animal tissue, such as from a pig. Your surgeon will help determine the best option for your specific situation.
What kind of medication might I be prescribed for aortic regurgitation symptoms?
If you develop heart failure as a complication, medication may be advised to help manage its symptoms. Examples include angiotensin-converting enzyme (ACE) inhibitors and 'water' tablets (diuretics).
Further reading and references
- Prophylaxis against infective endocarditis: Antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures; NICE Clinical Guideline (March 2008 - last updated July 2016)
- 2023 ESC Guidelines for the management of infective endocarditis; European Society of Cardiology (Aug 2023)
- Nishimura RA, Otto CM, Bonow RO, et al; 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. Circulation. 2017; CIR.0000000000000503. Originally published March 15, 2017.
- Vahanian A et al; Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology, 2017
- Ozkan M; What is new in ACC/AHA 2017 focused update of valvular heart disease guidelines. Anatol J Cardiol. 2017 Jun;17(6):421-422. doi: 10.14744/AnatolJCardiol.2017.7925.
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About the authorView full bio
Dr Colin Tidy, MRCGP
General Practitioner, Medical Author
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.
About the reviewerView full bio
Dr Adrian Bonsall, MBBS
Medical Author
MA (Chemistry), MBBS (Hons), DCH
Since 2000 Adrian has been employed in emergency and critical care paediatrics based in Sydney, with particular interests in toxicology, trauma and resuscitation.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
1 Aug 2017 | Latest version
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