Aortic Regurgitation Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Aortic insufficiency, also known as aortic regurgitation, is a condition in which the aortic valve does not close completely.
The heart has four valves, namely the aortic, pulmonary, mitral and tricuspid valves. Under normal circumstances, when the heart muscle relaxes, blood enters the heart. To prevent blood from leaking out of the heart prematurely, the aortic valve closes. In aortic insufficiency, the aortic valve cannot close completely so that some of the blood leaks out of the heart.
Symptom
Aortic insufficiency can occur acutely or chronically. The two types of aortic insufficiency have different symptoms.
The main symptoms of acute aortic insufficiency are sudden severe shortness of breath and chest pain. Meanwhile, chronic aortic insufficiency generally does not have any symptoms for years. If there are symptoms, the symptoms of chronic aortic insufficiency are generally in the form of palpitations, shortness of breath intermittently, sudden cardiac arrest can also occur which can lead to death.
In addition, other symptoms that can occur are:
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Easily tired
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Weak body
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Shortness of breath that gets worse when doing activities
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Chest pain that worsens with activity and improves with rest
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Dizzy like flying
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Faint
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Irregular heart rhythm
Reason
There are many causes of aortic insufficiency. Among others are:
- Congenital defects (the most common cause)
- Rheumatic fever
- Infective endocarditis
- Heart injury
- Operation complications
- Degenerative (aging)
- Uncontrolled hypertension
- Marfan’s Syndrome
- Syphilis
- Autoimmune diseases such as Takayasu’s arthritis and giant cell arthritis
Diagnosis
If there is a suspicion of aortic insufficiency, the initial examination to be carried out is:
- Examination of the heart record to assess the electrical activity of the heart (electrocardiogram / EKG)
- Chest X-ray
- Routine blood tests
To confirm the suspicion of aortic insufficiency, it is necessary to do an echocardiogram examination. This examination is useful for seeing the condition of the heart valves and assessing valve leaks that occur.
In addition, it is necessary to do an examination to find out the cause of aortic insufficiency. If the cause is suspected due to infective endocarditis, it is necessary to do a blood culture to confirm the diagnosis. However, if it is suspected that the cause is due to rheumatic fever, it is necessary to do a blood test in the form of anti-streptolysin O titer (ASTO) and complement C3, as well as a throat swab examination.
Treatment
If the aortic insufficiency is due to infective endocarditis, then surgery should be performed as soon as possible. The operation performed was an operation to replace the aortic valve with an artificial heart valve. To prevent complications from surgery, patients need to be given blood-thinning drugs such as aspirin and given antibiotics, before surgery is carried out.
While waiting for surgery preparations, drugs in the form of diuretics, nitrates, and digoxin, need to be given to reduce the burden on the heart due to valve abnormalities that are experienced.
Although the main treatment for aortic insufficiency is open surgery, if the symptoms are severe enough, surgery carries a high risk. Therefore, in special conditions, an alternative action that can be taken is transcatheter aortic valve replacement (TAVR).
In TAVR, open surgery is not performed. The act of using a catheter tube that is inserted through a blood vessel in the groin area (femoral artery). Once the catheter reaches the heart, a prosthetic heart valve will be inserted to replace the damaged heart valve. This procedure is less invasive than open surgery. However, it takes highly skilled personnel to do so.
If aortic insufficiency shows no symptoms at all, then surgery does not have to be done immediately. However, sufferers must undergo regular monitoring every month or every few months to assess the condition of the aortic valve.
Prevention
Until now there is no action that can prevent the occurrence of aortic insufficiency.