Aortic Regurgitation: Symptoms and Health Implications

Heart valve issues

Hello Dr.
Zhong,
I would like to ask you about the effects of aortic regurgitation on the body.
I was hospitalized for a month due to bacterial endocarditis after catching a cold on April 21, and I was diagnosed with moderate regurgitation on May 23.
Sometimes I experience chest pain, but it's not very severe; it comes in short, intermittent episodes lasting less than a minute.
However, I often feel discomfort in my left chest, and recently I've also been experiencing pain in my left back and occasional soreness in my left arm.
My condition seems to have worsened compared to before.
The doctor mentioned that about 30% of my blood is regurgitating.
I previously discussed my symptoms with my doctor, and I was prescribed Cardiolol 10 mg, but it hasn't improved my symptoms.
What should I do? Am I at risk of worsening? Thank you, Dr.
Zhong, and I apologize for the disturbance.

Carol, 20~29 year old female. Ask Date: 2002/11/20

Dr. Zhong Yuxun reply Cardiology

Hello! You have been diagnosed with bacterial endocarditis affecting the aortic valve, complicated by moderate aortic regurgitation.
This is a more complicated condition; moderate blood backflow may present some symptoms, and you might consider discussing medication options with your physician to improve your condition.
Bacterial endocarditis can potentially invade nearby tissues, so chest pain may warrant consideration of whether the coronary arteries (the vessels supplying blood to the heart) are involved.
You should consult your physician and arrange for further examinations if necessary.
In summary, this condition requires patience, as well as regular and long-term follow-up and treatment.
Wishing you and your family peace and happiness.
Sincerely, Dr.
Chung Yu-Hsuan, Director of Cardiology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2002/11/20

More Info

Aortic regurgitation (AR) is a condition where the aortic valve does not close properly, allowing blood to flow back from the aorta into the left ventricle during diastole. This can lead to a variety of symptoms and health implications, particularly as the condition progresses.
In your case, having experienced bacterial endocarditis, which can damage heart valves, it is understandable that you are concerned about the implications of moderate aortic regurgitation. The symptoms you describe, such as chest discomfort, left back pain, and left arm soreness, can indeed be associated with AR, especially if the heart is struggling to manage the volume overload caused by the regurgitation.

Symptoms of Aortic Regurgitation
1. Shortness of Breath: This can occur during exertion or when lying flat, as the heart struggles to pump effectively.

2. Fatigue: Due to decreased cardiac output, patients often feel more tired than usual.

3. Palpitations: You may experience a sensation of your heart racing or pounding, particularly during physical activity.

4. Chest Pain or Discomfort: As you mentioned, this can be intermittent and may not be severe but can be concerning.

5. Swelling: In advanced cases, fluid may accumulate in the legs or abdomen.

Health Implications
The backflow of blood into the left ventricle can lead to several complications over time:
- Left Ventricular Hypertrophy: The heart muscle thickens as it works harder to pump the increased volume of blood, which can eventually lead to heart failure.

- Heart Failure: If the left ventricle becomes too dilated or weakened, it may not be able to pump blood effectively, leading to symptoms of heart failure.

- Arrhythmias: The structural changes in the heart can lead to irregular heartbeats, which may explain some of your discomfort.

- Increased Risk of Endocarditis: With a damaged valve, there is a higher risk of recurrent infections.

Management and Treatment
Given that your symptoms have not improved with Cardiolol (a beta-blocker), it may be time to reassess your treatment plan. Here are some considerations:
1. Regular Monitoring: Regular follow-ups with your cardiologist are crucial. They may recommend echocardiograms to monitor the progression of your regurgitation and the function of your heart.

2. Medication Adjustment: If your current medication is not alleviating your symptoms, discuss with your doctor the possibility of adjusting your dosage or trying different medications. Sometimes, diuretics may be prescribed to help manage fluid overload.

3. Lifestyle Modifications: Maintaining a heart-healthy lifestyle can help manage symptoms. This includes a balanced diet, regular exercise (as tolerated), and avoiding excessive salt intake.

4. Surgical Options: If your symptoms worsen or if there is significant left ventricular dysfunction, surgical intervention may be necessary. This could involve repairing or replacing the aortic valve.

Conclusion
It is essential to communicate openly with your healthcare provider about your symptoms and concerns. If you feel that your current treatment is not effective, do not hesitate to seek a second opinion or ask for a referral to a specialist in valvular heart disease. Early intervention can significantly improve outcomes and quality of life. Remember, managing aortic regurgitation effectively requires a comprehensive approach that includes both medical management and lifestyle adjustments.

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