Causes of Aortic Valve Regurgitation

Aortic valve regurgitation, also known as aortic insufficiency, occurs when the heart's aortic valve doesn't close properly, causing blood to leak back into the left ventricle. There are several underlying causes of this condition, which can be broadly categorized into congenital and acquired factors.

Congenital Causes

One of the primary causes of aortic valve regurgitation is a congenital abnormality, meaning the condition is present at birth. Normally, the aortic valve consists of three leaflets or cusps. However, some individuals are born with only two cusps, a condition known as bicuspid aortic valve. This structural anomaly can lead to improper valve closure, resulting in blood flowing backward into the heart. While some people with a bicuspid valve may not experience symptoms early in life, others may develop regurgitation over time due to increased stress on the valve.

Acquired Causes

In addition to congenital defects, aortic regurgitation can also develop later in life due to various acquired conditions. One of the more common causes among younger individuals is infective endocarditis—an infection of the heart's inner lining and valves. This infection can be triggered by bacteria entering the bloodstream, often from dental procedures, skin infections, or even severe respiratory illnesses like pneumonia. When the infection affects the aortic valve, it can cause damage such as perforation or rupture of the valve leaflets or the supporting tendon-like cords (chordae tendineae), ultimately leading to regurgitation.

Age-Related Degeneration

Among older adults, degenerative changes due to aging are a major cause of aortic valve regurgitation. As people age, the aortic valve may become thinner and less flexible, and the chordae tendineae may lengthen or rupture. These structural changes impair the valve's ability to close tightly. Additionally, conditions like rheumatic heart disease—often the result of untreated streptococcal infections—can lead to chronic inflammation and scarring of the valve, further contributing to regurgitation.

Other Contributing Factors

Other potential causes include hypertension, aortic dissection, and connective tissue disorders such as Marfan syndrome. These conditions can stretch or weaken the aorta and the valve structure, increasing the risk of leakage. Early diagnosis and treatment are essential to prevent complications like heart failure or arrhythmias.

Understanding the root causes of aortic valve regurgitation is crucial for effective management and treatment. If you experience symptoms such as fatigue, shortness of breath, or chest pain, it's important to consult a cardiologist for proper evaluation and care.