Understanding Aortic Regurgitation: Recognising the Subtle Signs

Aortic regurgitation (AR) is a condition that often flies under the radar, particularly among older adults. It occurs when the aortic valve in the heart doesn’t close properly, allowing blood to flow backwards into the heart instead of moving forward through the body. Over time, this can place extra strain on the heart, leading to serious health complications. However, the symptoms of AR can be so subtle that many people don’t even realise they have it until it’s advanced.

What Is Aortic Regurgitation?

Aortic regurgitation happens when the aortic valve fails to close tightly. This causes blood to leak backwards into the left ventricle after it has been pumped out of the heart. As a result, the heart has to work harder to pump enough blood to meet the body’s needs. Over time, this extra workload can cause the left ventricle to enlarge and weaken, leading to heart failure if left untreated.

Symptoms of Aortic Regurgitation

It’s important for older adults to be aware of the subtle symptoms of AR, as early detection can make a significant difference in treatment outcomes. Here are some signs to be mindful of:

• Fatigue: Feeling unusually tired after normal activities.
• Shortness of breath: Especially during physical exertion or when lying down.
• Swollen ankles or feet: This can be a sign of fluid buildup due to heart strain.
• Chest pain or discomfort: This may occur during exertion.
• Palpitations: Feeling like your heart is skipping a beat or fluttering.

These symptoms can easily be mistaken for normal signs of ageing, but they shouldn’t be ignored. If you experience any of these, especially if they’re new or worsening, it’s important to speak to your doctor.

Prevalence: The Hidden Nature of AR

Many people with aortic regurgitation may not experience noticeable symptoms for years. This makes it particularly dangerous because by the time symptoms appear, the condition may have already caused significant damage to the heart. According to the OxVALVE study, aortic regurgitation was detected in 15% of participants aged 65 and older, with many cases being mild and undiagnosed. The HONU Valve Study also found that aortic regurgitation was one of the most common undiagnosed valvular diseases, affecting 4.5% of elderly participants.

Treatment

The most common treatment for Aortic regurgitation is surgical aortic valve replacement (SAVR) or, more recently, Transcatheter Aortic Valve Implantation (TAVI). Patients should consult with their clinician to discuss what treatment option is best for them.