What is Aortic Regurgitation?

Written by Nichole Owens
Medically Reviewed by Zilpah Sheikh, MD on April 14, 2025
6 min read

Your heart has four chambers, each with a valve that allows blood to exit.

Healthy valves open wide to let blood move freely through the heart and body. They then shut tightly until the next heartbeat.

If you have aortic regurgitation, the flaps around your aortic valve — the valve that pumps blood to your heart — don’t close fully. This causes blood to leak back into your left heart chamber. When this happens, your heart can’t pump blood to the rest of your body, as it should.

If you have advanced aortic valve regurgitation, it might cause serious problems.

Doctors may treat mild aortic valve regurgitation with medications and by closely tracking how you’re doing. They use a grading system, ranging from mild to severe, to find out how serious your aortic regurgitation is.

Trace aortic regurgitation. This is just what it sounds like. It means a small amount of blood (30% or less) flows back into your heart chamber. 

Mild aortic regurgitation. This means that the amount of blood flowing back into your heart chamber is between 30% and 39%.

Severe aortic regurgitation. The amount of blood flowing back into your heart chamber is 50% or higher.

“Aortic regurgitation has a prevalence of between 4.9% and 10%, based on population studies for all severities of regurgitation, with most of the cases being trace or mild,” says Eric Elgin, MD, Chief of the Division of Cardiology at Lehigh Valley Health Network in Pennsylvania.

“Moderate or severe regurgitation is much less prevalent, between 0.5% and 2.7%,” Elgin says.

Aortic valve regurgitation has several causes. Among them are:

Rheumatic fever

Strep throat can turn into rheumatic fever if it’s not properly treated. Rheumatic fever, which was once much more common in childhood than it is today, can damage your aortic valve. It is the most common cause of serious aortic valve regurgitation among older adults.

Congenital heart defect

Most aortic valves have three cusps. A somewhat common heart defect that people are born with is an aortic valve that has only two cusps or leaflets. Many mild cases of aortic valve regurgitation are caused by these “bicuspid aortic valves.”

Endocarditis

This is a swelling of the lining of your heart valves or chambers. This type of heart infection usually starts somewhere else in the body, then travels through your blood to your heart valves or chambers.

Aortic valve stenosis

This happens when your aortic valve can’t open all the way because it has become too thick and stiff. Sometimes, this condition can make it harder for the valve to close properly, causing regurgitation.

You can have aortic regurgitation for years without symptoms. You may not even know you have it. But as the condition worsens, you may have symptoms such as:

  • Chest pain that worsens during exercise
  • Fatigue
  • Feeling lightheaded or fainting
  • Shortness of breath with exercise or while lying down
  • Swollen ankles and feet
  • Rapid or irregular heartbeat

If you’ve had rheumatic fever or were born with a heart defect, you have a greater chance of having aortic regurgitation. You’re also more likely to develop it if you have high blood pressure, which can damage the part of the aorta where it meets the aortic valve.

Older adults are more likely than younger people to get this condition, as the flaps tend to stretch over time.

Left untreated, aortic regurgitation can lead to many problems, including:

  • Blood clots
  • Stroke
  • Heart failure
  • Irregular heart rhythms
  • Death if your heart suddenly stops

Even if you don’t have symptoms, your doctor may be able to detect aortic regurgitation by listening to your heart with a stethoscope.

If your doctor hears a whooshing sound in between beats, it could mean you have valve problems. The whooshing sound means there is an abnormal flow of blood through the valve.

If they suspect aortic regurgitation, your doctor may order one or more of the following tests:

  • Echocardiogram: Sound waves aimed at your heart create a video of it as it beats. This imaging test can help find aortic regurgitation and determine how seriously it’s interfering with healthy blood flow.
  • Chest X-ray: This can often tell if your heart is enlarged, possibly because of aortic regurgitation. An X-ray can also show whether your lungs have been affected by blood backing up in your heart.
  • Cardiac catheterization: Your doctor will do this test to see how bad your aortic regurgitation is. They’ll insert a flexible tube called a catheter through an artery and into your heart. They may also use special dye and an X-ray “movie” to get a more detailed look at your heart’s valves and chambers.

Mild regurgitation may not require any treatment. Your doctor may simply monitor it during your usual checkups. 

If you have high blood pressure, your doctor may prescribe medications and recommend lifestyle changes to bring it under control.

In more serious cases, aortic valve replacement may be the best option.

This can be done with traditional, open-heart surgery or with a relatively newer procedure known as transcatheter aortic valve replacement (TAVR).

You don’t have your chest opened with TAVR. Instead, your doctor uses a catheter that travels through an artery to the aortic valve.

Your doctor will insert a replacement valve at the site of your defective valve. Once the new valve is in place, your doctor takes out the catheter and your heart will continue to work as it once did.

There are no guaranteed ways to prevent aortic valve regurgitation. If you have strep throat, get treated before it progresses into rheumatic fever. You can also lower your risk for heart disease by keeping an eye on your blood pressure and practicing good health habits such as:

  • Exercise for at least 150 minutes a week.
  • Stay at a healthy weight.
  • Eat a good diet (the Mediterranean-style eating plan is a good choice).
  • Take the medications your doctor prescribes for any conditions you have.
  • Don’t smoke.

Aortic regurgitation happens when the flaps that open and close in your heart valve don’t work as they should. This causes blood to leak back into your heart chamber, instead of pushing it through your body.

Mild aortic regurgitation can be caused by many things. You might be born with it, or it could happen if you don’t get treatment for strep throat or other infections. 

Most cases of mild (trace) aortic regurgitation don’t need treatment. You can lower your risk with regular exercise, a healthy diet, and by managing any health conditions you might have, such as diabetes, high blood pressure, and high cholesterol.

How quickly does aortic regurgitation progress?

Usually, it progresses slowly. It also depends on how severe your case is, your age, and overall health. You can have mild aortic regurgitation for many years without any symptoms.

Can aortic regurgitation be reversed?

Typically, no. But if you have mild aortic regurgitation, your doctor can prescribe medicines and lifestyle changes to help lower your risk for heart disease. And you can have this condition for many years without having symptoms.

If you have severe aortic regurgitation, you may need surgery to fix it. Talk to your doctor.

What is the best exercise for a leaky heart valve?

Any type of regular, moderate aerobic exercise is best. You should also do some light resistance exercise, but avoid lifting heavy weights. It can increase the strain on your aortic valve.