Chronic and acute aortic valve (AV) regurgitation differ in their
onset, symptoms, causes, and treatment. Determining whether you have acute or
chronic regurgitation is important because the timing of treatment is very
different. The acute condition is a medical emergency that requires immediate
surgical intervention to prevent death. Chronic regurgitation, however, may not
need to be treated immediately with surgery. In fact, it is advisable not to
treat it surgically until it is bad enough to justify the risk of surgical
intervention.
This table shows the primary differences between the two
conditions.
Comparing chronic and acute aortic valve regurgitation | Characteristic | Chronic AV regurgitation | Acute AV regurgitation |
|---|
| Symptoms |
|
- Rapid heartbeat
- Shortness of
breath
- Tightness in chest
|
| Length of onset |
- Over the course of many months or
years
|
|
| Cause(s) |
- Rheumatic fever
- Infection in
the heart (endocarditis)
- Enlarged aorta (dilation of the aortic
root)
- Valves with two leaflets rather than three (congenital
bicuspid aortic valves)
|
- Separation of the inner layer of the aorta
from the middle layer (aortic dissection)
- Infection in the heart
(endocarditis)
- Trauma
|
Chronic aortic valve regurgitation
As the name implies, chronic regurgitation is a condition that you
will have over a long period of time, usually many years. It can worsen the
longer you have it. Chronic aortic valve regurgitation usually is not much of a
problem when you are initially diagnosed, but as your heart compensates for the
regurgitation, it eventually weakens. This causes the regurgitation to worsen
until you need surgical treatment. Surgery for a chronic condition is generally
avoided until it is necessary to preserve your heart function.
Additionally, most people do not have any symptoms when they
develop chronic regurgitation. It is not until later stages of the condition
that most people notice symptoms.
Acute aortic valve regurgitation
Acute regurgitation is caused by infection in the heart
(endocarditis), separation of the inner layer of the aorta from the middle
layer (aortic dissection), or trauma. The net result of aortic dissection is a
large amount of blood suddenly leaking back into the left ventricle. Your heart
has not had time to develop coping mechanisms for leaking blood. This may cause
your heart to beat very rapidly in an attempt to move enough blood through your
body, but often this is not enough, and surgical intervention is needed.
Unlike the chronic condition, the rapid onset of acute
regurgitation does cause symptoms immediately. Rapid heartbeat (tachycardia) is
a common symptom as the heart tries to increase the volume of blood that it
pumps. Acute regurgitation can also lead to other irregular heartbeats
(arrhythmias), fluid buildup in the lungs (pulmonary edema), and critically low
blood output by the heart (cardiogenic shock), all of which can cause sudden
death. It is imperative that you seek surgical treatment for acute
regurgitation immediately to prevent this.
