Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). Aortic regurgitation means the aortic valve leaks, allowing blood to flow back into the heart's main pumping chamber with each beat.
A bicuspid aortic valve, dilation of the aortic root, previous rheumatic fever, endocarditis, connective tissue disorders such as Marfan syndrome, and age-related valve degeneration.
Mild leaks cause no symptoms and are often found when a murmur is heard (see /conditions/heart-murmur). More significant regurgitation causes breathlessness on exertion, fatigue, palpitations and awareness of a forceful heartbeat.
Echocardiography grades severity, measures the aortic root, and tracks the size and function of the left ventricle over time. Serial scans are the cornerstone of management because the timing of surgery depends on trends, not a single measurement.
Mild and moderate regurgitation is monitored with periodic echocardiograms and blood pressure control. Severe regurgitation with symptoms, or with early enlargement or weakening of the left ventricle, is an indication to consider valve repair or replacement.
No. Aortic regurgitation does not resolve spontaneously, but mild leaks frequently remain stable for many years and require nothing more than periodic echocardiographic surveillance.
Typically every 3–5 years for mild regurgitation, every 1–2 years for moderate, and at least annually for severe or where the aorta is enlarged. Your cardiologist sets the interval based on your measurements.
Most people with mild or moderate regurgitation can exercise normally. Restrictions are individualised for severe regurgitation or an enlarged aorta, so ask your cardiologist rather than assuming.
No. Many people never require an operation. Surgery is considered when regurgitation is severe and either symptoms appear or the left ventricle begins to enlarge or weaken on serial imaging.