Department of cardiac muscle pathology and transplantation of organs and tissues

Aortic valve insufficiency

Aortic insufficiency: Etiology, signs and symptoms, diagnostics and methods of treatment

Aortic valve insufficiency (aortic insufficiency) is characterized by incomplete closure of the valve cusps during the diastole, resulting in the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle of the heart. In more than in 50% of patients, these disorders are accompanied by aortic ostium stenosis.

Etiology and risk factors

Inborn factors: A congenital defect that may be represented by 1-, 2- or 4-cuspid aortic valves instead of a normal 3-cuspid; interventricular septum malformation accompanied by the cusps’ prolapse; aortic dilation due to some connective tissue diseases.

Acquired factors: Rheumatoid arthritis (up to 80% of cases), autoimmune diseases (systemic lupus erythematosus, Takayasu disease), Infectious endocarditis, aortic sclerosis, (traumatic lesions, incl. cardiac surgery), myocardial infarction as one of the main factors of the left ventricle aneurysm, and aortic defects due to Marfan syndrome.

Stages, signs and symptoms

There are 5 stages varying from a complete asymptomatic compensation to terminal stage, which is accompanied by severe heart insufficiency, i.e. dyspnea and cardiac asthma attacks, chest pain, arrhythmia, anginal attacks, peripheral edema, ascites, and pulmonary edema.


  • ECG that shows the condition of the left ventricle
  • Phonocardiography that detects changed or abnormal heart sounds
  • X-ray and coronary cardiography
  • EchoCG that reveals specific signs of aortal disorders
  • Heart catheterization that defines such parameters as cardiac output, left ventricular end-diastolic volume, and volume of blood regurgitation into the left ventricle
  • MRI of heart and multislice spiral CT

Methods of treatment

In moderate asymptomatic stage the doctor prescribes diuretics, calcium channel-blocking agents, ACE inhibitors, angiotensin receptors antagonists, cardiac glycosides, β-blockers, and anticoagulants.
Surgery is conducted in the case of the pronounced or severe symptomatic aortic valve insufficiency and involves transplantation, aortic valve reconstruction (valvuloplasty), and more often – a prosthetic valve implantation.

In the case of a pronounced aortic valve insufficiency without signs of decompensation, the average life expectancy since the moment of diagnostics comprises 5 to 10 years. The prevention of aortic valve insufficiency includes timely diagnosing and treatment of rheumatism, infectious diseases and atherosclerosis, as well as follow-up of patients from the risk groups.



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