Aortic insufficiency is a potentially severe condition that affects the heart’s ability to pump blood. There are many possible causes for this condition.

Aortic insufficiency is a form of heart valve disease where the aortic valve in the heart is leaky and does not close tightly enough.

A person’s aortic valve controls blood flow from the heart to the body. It has flaps that open to allow blood to leave the heart. These valves close when the heart fills. If the flaps do not close tightly enough, the valve leaks, allowing blood to flow backward during heartbeats.

There are several causes of aortic insufficiency, including heart abnormalities, aging, and injury.

People with aortic insufficiency may initially have no symptoms. Over time, symptoms can develop as the condition worsens. A person’s heart must work increasingly hard to compensate for the backward heart blood flow. This can eventually lead to heart damage and failure.

Doctors may be able to treat mild aortic insufficiency with medications. However, people with progressing aortic insufficiency generally need aortic valve replacement surgery.

This article discusses aortic insufficiency causes, risk factors, and prevention. It also outlines when a person needs to consult a doctor.

Professional Healthcare Check-Up Nurse Monitoring Baby's Pulse on Adorable Tiny FootShare on Pinterest
skaman306/Getty Images

People can develop aortic insufficiency because of conditions that damage their aorta or heart tissues. Some individuals may have aortic insufficiency due to congenital conditions, which are conditions they are born with.

A person’s aortic valve typically has three small parts or leaflets. If they have a bicuspid aortic valve (BAV) birth abnormality, they have two leaflets instead of three.

Approximately 1% of people have a BAV abnormality.

In some cases, a person may have a unicuspid or quadricuspid aortic valve with one or four leaflets. Having a BAV abnormality or other conditions that cause an aortic valve with an atypical number of leaflets may lead to complications, including aortic insufficiency.

Other causes of severe aortic insufficiency include:

  • Rheumatic heart disease (RHD): RHD is a common cause of aortic insufficiency in some parts of the world. It is a complication of rheumatic fever.
  • Narrowing of the aortic valve: Calcific aortic stenosis is a narrowing of the aortic valve. This is due to a buildup of calcium deposits. Sometimes, this calcium can prevent the valve from closing properly, resulting in aortic regurgitation.
  • Aortic aneurysm: Aortic aneurysm, which is dilation of the aorta due to high blood pressure, smoking, or genetic conditions, can lead to progressing aortic insufficiency.
  • Infective endocarditis: Infective endocarditis is an infection of a person’s inner heart lining and valves that can lead to aortic insufficiency.
  • Untreated syphilis: Untreated syphilis can progress over time to advanced syphilis. In some cases, this can cause heart problems, including aortic insufficiency.
  • Injury: In some cases of blunt force trauma, people may experience aortic valve injury, which can cause aortic insufficiency.

Other possible causes of aortic insufficiency include:

Aortic insufficiency may be more common in males than females. It is also more likely in people in their 40s to 60s.

Other common risk factors for aortic insufficiency include:

  • chronic kidney disease
  • frequent infections
  • intravenous drug use, which involves injection via the veins, which can lead to endocarditis
  • rheumatic fever
  • high blood pressure, which can lead to aortic aneurysm
  • undergoing radiation therapy in the chest area

People cannot prevent aortic insufficiency resulting from birth-related heart abnormalities.

Doctors may recommend surgery to repair or replace a person’s aortic valve. However, repair is typically only an option if the damage to the valve is minimal.

People without a congenital heart abnormality can take the following steps to reduce their risk of developing aortic insufficiency:

  • taking antibiotics when they have strep throat to prevent rheumatic fever and avoid complications
  • managing blood pressure
  • managing their blood sugar
  • getting regular cholesterol level checks
  • reducing their risk of endocarditis by:
    • practicing appropriate dental hygiene
    • getting regular dental checks
    • taking any prescription antibiotics before dental or other medical procedures

People with mild aortic insufficiency may have few or no symptoms. They may develop symptoms as the condition worsens over time.

People with severe aortic insufficiency may have symptoms such as:

  • chest pains or chest tightness, particularly during or after physical activities
  • difficulty breathing when lying down
  • fainting
  • fatigue
  • heart murmurs
  • heart palpitations
  • irregular heartbeats
  • shortness of breath
  • swollen ankles or feet
  • weakness, or feeling tired or weak during periods of increased activity

If a person experiences these symptoms or their symptoms do not improve with treatment, they need to seek immediate medication attention.

Aortic insufficiency is when a person’s aortic heart valve leaks blood backward. It can have many causes.

Some people are born with birth abnormalities that can cause the condition. Individuals may also develop aortic insufficiency due to aging, infections, or other conditions.

If the condition worsens, people may need an aortic valve replacement.