Aortic Regurgitation, Adult (Aortic Insufficiency)
- Aortic regurgitation, incompetence or insufficiency “AR/AI” is abnormal back flow of blood from the aorta to the left ventricle during diastole due to pathology affecting the valve or the aorta leading to inadequate closure of the valve leaflets.
- It can be acute or chronic.
- No data are available.
- Trace aortic incompetence is common even in healthy subjects.
- Less prevalent than other valvular regurgitation
- Male > female: 13:8.5% (1)
- In United States, estimates of the prevalence of AR of any severity range from 2% to 30%, but only 5–10% of patients with AR have severe disease, resulting in an overall prevalence of severe AR of <1% in the general population.
- Prevalence increases with age.
Etiology and Pathophysiology
- According to presentation
- Acute AR: endocarditis, dissection, and trauma. No time for adaptation leads to pulmonary edema and decreased cardiac output.
- Chronic AR: gradual hypertrophy and dilatation of the left ventricle that progresses to pulmonary edema then heart failure, if untreated
- Geographical variation
- Other causes: idiopathic aortic dilation, cystic medial necrosis, senile aortic ectasia and dilatation, syphilitic aortitis, inflammatory vascular diseases, and postsurgical
- Marfan syndrome: autosomal dominant connective tissue disorder; mutation in the FBN1 gene
- Bicuspid valve
- Uncontrolled blood pressure (BP)
- Intravenous drug use that may lead to endocarditis
- Aortic stenosis
- Old age
Control risk factors:
- Control BP.
- Stop smoking; exercising and healthy diet
- Avoid drug abuse.
- Infective endocarditis prophylaxis when appropriate
Commonly Associated Conditions
Bicuspid aortic valve
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Domino, Frank J., et al., editors. "Aortic Regurgitation, Adult (Aortic Insufficiency)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816831/all/Aortic_Regurgitation__Adult__Aortic_Insufficiency_.
Aortic Regurgitation, Adult (Aortic Insufficiency). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816831/all/Aortic_Regurgitation__Adult__Aortic_Insufficiency_. Accessed June 5, 2023.
Aortic Regurgitation, Adult (Aortic Insufficiency). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816831/all/Aortic_Regurgitation__Adult__Aortic_Insufficiency_
Aortic Regurgitation, Adult (Aortic Insufficiency) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 05]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816831/all/Aortic_Regurgitation__Adult__Aortic_Insufficiency_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Aortic Regurgitation, Adult (Aortic Insufficiency) ID - 816831 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816831/all/Aortic_Regurgitation__Adult__Aortic_Insufficiency_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -