Difference between aortic stenosis and aortic regurgitation?

Types of aortic valve problems

The aortic valve acts as a connection between the left ventricle of the heart and the aorta, the major blood artery that emerges from the heart.

Aortic stenosis occurs when the valve narrows and cannot fully open, hence restricting blood flow forward. Aortic regurgitation occurs when the valve fails not to close completely, allowing blood to leak back into the left ventricle. Both conditions can occur alone or together. The underlying reason may be present from birth (congenital) or acquired later in life.

A normal aortic valve consists of three tissue flaps referred to as leaflets or cusps. However, approximately 1% to 2% of persons are born with a bicuspid aortic valve, meaning their aortic valve has only two leaflets. Without the third, the valve may not open completely, resulting in stenosis. Alternatively, it may not completely close, resulting in regurgitation. Occasionally, infants born with aortic valve stenosis (most commonly caused by a bicuspid valve) have valves that are so thin that they experience symptoms before reaching their first birthday. However, the majority of people are unaware they have aortic stenosis until later in life, when a doctor hears a murmur (an abnormal heart sound) or they experience symptoms. These include chest pain, breathlessness, fatigue, swelling ankles, and palpitations (a sensation of extra or skipped heartbeats).

Previously, rheumatic fever was a common cause of acquired aortic stenosis, which occasionally developed following a strep throat infection. Antibodies directed against the infection attacked the valve leaflets, stiffening and fusing them together. However, antibiotics have virtually eradicated rheumatic fever in children and adults born and nurtured in this country.

Today, the majority of cases of aortic stenosis are caused by the wear and tear of aging, which results in the degeneration of the leaflets. Typically, the valve thickens and narrows as a result of calcium deposition on the leaflets. However, regurgitation can occur, and the symptoms are identical to those associated with stenosis. Aortic regurgitation may also occur as a result of rare conditions that expand the aorta and aortic valve, such as Marfan's syndrome, a connective tissue disorder. Additionally, some autoimmune diseases, such as lupus, can result in aortic regurgitation.

If a doctor finds a heart murmur, an echocardiogram (ultrasound of the heart) is required to rule out a leaky or rigid aortic valve. Individuals with mild stenosis or regurgitation who exhibit no symptoms should be followed by a cardiologist on a regular basis. They may require a valve replacement if the condition worsens. While some people with aortic stenosis require surgery, many are candidates for a less invasive, non-surgical procedure called transcatheter aortic valve replacement.

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