Aortic insufficiency

What is Aortic insufficiency?

Aortic insufficiency is the incompetence of the aortic valve to close when it has to. Thus the blood emptied into the aorta leaks back into the left ventricle decreasing the amount of blood reaching the peripheral organs.

Questions and answers on "Aortic insufficiency"

Hi, I have a heart murmur, in particular a bicuspid aortic valve with minor to moderate regurgitation. I am 18. I want to build some muscle mass, I have a very thin build. However I understand that weightlifting is a bad idea for me. Any thoughts/ideas?

doctor1 MD

Hi XXXXXXX

Thanks for the query.

Unfortunately yours is a condition where physical activity has to be limited. About weight lifting please discuss with your doctor as it depends upon the left ventricular cardiac function, also for any kind of exercises including walking. If your regurgitation is...

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HeIlo,

Im looking for some advice from a cardiac specialist. I know that I should seek advice from my treating physician but I am just after some guidance. Here is my history.

I am a 72 year old male with history of right pneumonectomy due to TB back in 1960. As a result of this procedure I have been under treatment for COPD since then. I have lived a full life and managed very well with my condition. I have no other medical conditions.
A few years ago I had an acute exacerbation of my condition and was found to be in type II respiratory failure. I have been a chronic CO2 retainer since. Regardless of this, I have managed well on nebulised bronchodialators and nebulised steroids.
Last year I had another acute exacerbation and was admitted into hospital where I was put under the care of a new Respiratory Consultant. This consultant put me on home BIPAP therapy designed to manage my CO2 retention. I use this non invasive ventilator 8-9 hours per day (so usually over night). Once again, whilst on the BIPAP therapy, I have previously been managing well and still active.

Last month I began to progressively become more and more breathless on exertion. At rest I was fine with my sats in high 90’s. But on slight exertion I would desaturate to the 80’s and become dyspnoeic. I do not feel faint and have not suffered syncope. At its worst I got peripheral eodema – swelling in my ankles and feet with pitting. My hands also became swollen. This resolved after a few days. Currently I have no peripheral eodema. I am fantastic at rest and have even clocked my resting sats at 99%. But on exertion I become very very breathless. Even when walking across the room. I also feel pressure around my chest sometimes. This isn’t acute pain or radiating pain or crushing pain associated with MI or angina. This is just a dull, long lasting feeling of weight on my chest. It is worse when I lie down. In fact I am unable to lie down.

I spoke to my respiratory consultant about this and he ordered an echo. I had my echo last week. I am very interested to see if there is evidence of CHF or Pulmonary hypertension. I am yet to hear from my consultant but he implied that the next step would be to put me on ambulatory oxygen. He said the respiratory nurses will deal with that and that I was to see him in 6 months for a review appointment.

Now here is where I would like my guidance.
I am a bit worried that my doctors will put me on ambulatory oxygen to relieve the symptoms without trying to resolve the underlying condition. I am also worried that wont get to talk to a doctor about the results of my echo. If my echo shows evidence of CHF or Pulmonary hypertension, should I be requesting that pharmacological intervention (ACE inhibitors, digoxin, diuretics, ect) be carried out to relieve the strain and load on my heart which may relieve the breathlessness? Or should I just accept the fact that I have to carry round oxygen wherever I go? Is oxyen a first line treatment? Should I be speaking to a cardiologist or is a respiratory specialist adequate to manage my condition?
I just want some information at hand for when I have this discussion with the department.
What I have also noticed is that previously, my usual resting HR was between 95-105. Tachy for normal people but it seemed to be normal for me, on account of my one lung. Recently my HR is always low at 70-80. Even when breathless and exerting myself it rarely goes as high as it used to. Am I showing signs of decompensation? Is my heart no longer able to compensate and keep up?

We don’t have the results of my echo yet, but what are my options?

Thank you for your help.

doctor1 MD

Hi,
I am pleased to know that you are taking really good care about your health parameters and your knowledge is also good.

What I can summarize from your history is

1 COPD with chronic type 2 respiratory failure on daily oxygen therapy
2 developing signs of congestive heart failure like edema,...

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I am a female 72, 5'4" 195lbs. with End stage Kidney disease, Aortic stenosis and what my cardiologist called a "stiff heart". My LDL is normal. My Blood pressure is systolic high 187 and diastolic 74. I am taking amlodipine 2.5mg. This evening Ihave been experiencing a gushing sensation under my left breast since 5pm EST which is still continuing. I am worried about and would like to know what I should do? XXXXXXX

doctor1 MD

Hello XXXXXXX

Thanks for posting your query.

What you are already having i.e. aortic stenosis and cardiac stiffness ( most probably due to cardiac amyloidosis ) may cause the left ventricle to work harder to pump blood into the aorta and deposits of an abnormal protein (amyloid) in the heart...

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Why do I get an annoying pulsating sensation in upper neck area when I lay down to sleep. I do take three blood pressure medicienes (tekturna-300mg, metoprolol-100mg, losartin-100mg, hydrazaline-100mg, asprin-81mg, potassium-500mg, ferosumeide-80mg, Also, insulin 120 units for diabetes.

doctor1 MD

Hi ,

Thanks for your query.

Annoying pulsating sensation in the upper neck area can be caused due to the following causes:
1)Most commonly it is seen with Anxiety.
2)Tachycardia(an increase in the normal heart rate above 100 beats per minute) associated with high Blood pressure since you are...

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what happens when my heart rate was 117 and i am sitting..not running......and my blood pressure was 130 /56 I am 61 and 5'1" and 135 lbs.

doctor1 MD

hi XXXXXXX,
thanks for the query.

according to your findings you are having,
tachycardia,
high systolic or as you are hypertensive with 61 years age it can be taken as normal systolic,
low diastolic pressure,
wide pulse pressure= 130-56=74

the possible causes for these findings are,...

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i had a quadruple bypass 7 weeks ago. by all tests i am doing well. there was no heart attack. i have been walking every morning. what is my target heart rate for exercise? and how many minutes per day or week should i walk (once i build up to it). i am 59, male, not overweight. Thanks.

doctor1 MD

Hello Mr XXXXXXX

Thank you for your query.

Since you could discover the major blockages in your coronary arteries before an attack and since you could successfully get a bypass surgery done, I think that your overall prognosis is good.

Walking is a very good form of exercise for you. Since it is...

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I would like to request your opinion input analysis regarding the following description of an ascending aortic dilation that was recently accidently diagnosed about me. It has me worried. I am a 60 year old male, 5’10” in height, and weigh 180 lbs. My BSA is 2.04 and my BMI is 24.88. I have felt to be in overall good physical condition all my life with the exception of degenerative disc disease operations for my neck and lower back.
This past XXXXXXX 2011, I had a CT scan with contrast as part of testing to address a dry cough that I had. During this procedure that found a small 5mm lung nodule, it was also noted from the CT that I have a fuseform type of enlargement of my ascending thoracic aorta that they indicated in two locations as 42.5mm and two frames higher as 43.5mm in diameter. My family physician at that time recommended another CT in 6 months to monitor these findings. Because of my concern, he also referred me to a cardiologist for discussion of this. The cardiologist performed an EKG which was fine and stated that he would also perform an echocardiogram at the time of the 6 month CT.
I had the second CT with contrast in late December 2011 and the echocardiogram the very next day. The second 6 month CT scan indicated that both the lung nodule and aortic dilation as “stable” for their purposes. (The periodic cough is still with me mostly in the evening before bed. It is suspected to be caused by acid reflux and I’m going in for further ENT tests) The aortic area that was formerly noted as 42.5mm in diameter this time had a notation of 42.6mm with no additional notations. When the echocardiogram results came back and I had my meeting with the cardiologist, he showed me how he could measure the mid-ascending area as 44.2mm. Aortic walls appeared good with no indications for dissection. Other measurements on the echo for the aorta area indicate a mildly thickened normal functioning tricuspid aortic valve with no aortic valve regurgitation. There is moderate-severe Sinus of Valsalva dilation at 50mm. Sino-Tubular Junction measures 39mm, Aortic Arch measures 34mm, and Upper Abdominal location as 18mm. This Sinus of Valsalva finding at 50mm has really given me additional concern but my cardiologist doesn’t seem as concerned about this and has recommended another CT one year out for monitoring the mid-aorta, etc. I mentioned that I had read in Wikipedia that a 50mm Sinus of Valsalva aneurysm is “an indication for surgery”. cardiologist opinion is that this would be a very aggressive response at this time. The cardiologist believes my aortic condition most likely developed over many years as congenital or from atherosclerotic causes. Overall, he indicated to me that from my test results, my measurements appear as “stable” but that he wants to look at that third point of reference in a year because a mm difference on test results can also be interpreted for test difference error. I was put on a prescription for 25mg of Metoprolol Tartrate to control any periodic blood pressure issues that sometimes ranged 120-160mmHg. I have also been on 20mg Atorvastation or Lipitor for the past 10 years.
I am wondering what another cardiologist’s opinion might be for me. As I stated, I am worried about my prognosis and am hoping my measurements do not grow to a dissection or rupture emergency. I am also concerned about potential future surgery for this as I understand the procedure is quite invasive and risky. I also do not wish to be sitting on a “ticking time-bomb” when some other intervention should be considered. I would like to request your input regarding my condition, especially regarding the ascending aortic dilation and sinus of valsalva. Do you feel that I need to seek out additional opinion as to actions that need to be followed now?
For your information, the following are the full result findings indicated on the echocardiogram report that I had in December:
Impressions:
1.      Normal left ventricular chamber size. Calculated EF; 66%.
2.     No regional wall motion abnormalities.
3.     Grade ¼ left ventricular diastolic dysfunction, consistent with low to normal left ventricular filling pressure.
4.     Valve changes consistent with patient age at 60. Tricuspid aortic valve.
5.     Moderate-severe sinus of Valsalva dilation (diameter 50mm)
6.     Moderate ascending aorta dilation (diameter 44 mm at mid level).
Findings:
LEFT VENTRICLE: Normal left ventricular chamber size. Normal left ventricular wall thickness. Normal left ventricular systolic function. Calculated left ventricular ejection fraction; 66%. No regional wall motion abnormalities. Grade ¼ left ventricular diastolic dysfunction, consistent with low to normal left ventricular filling pressure. RIGHT VENTRICLE: Normal right ventricular size. Normal right ventricular systolic function. Unable to detect peak tricuspid regurgitation velocity for pulmonary artery systolic pressure calculation. ATRIA: Borderline left atrial enlargement. Left atrial volume index 29 cc/mm2. Normal right atrial size. CARDIAC VALVES: Mildly thickened aortic valve. No aortic valve regurgitation. Mildly thickened mitral valve. Trivial mitral valve regurgitation. Normal pulmonary valve. Trivial pulmonary valve regurgitation. Normal tricuspid valve. Trivial tricuspid valve regurgitation. OTHER ECHO FINDINGS: Moderate ascending aorta dilation (diameter 44 mm at mid level). Moderate-severe sinus of Valsalva dilation (diameter 50 mm). No intracardiac mass or thrombus, but the left atrial appendage cannot be visualized adequately with transthoracic echo to exclude thrombus in this location. No pericardial effusion. Normal inferior vena cava size with normal inspiratory collapse (>50%).
Again, I thank you for any input, information, or help you can give me regardingmy health situation.
Sincerely, XXXXXXX Hofmeister
1405 Lor XXXXXXX Drive
North Mankato, MN 0000
YYYY@YYYY

doctor1 MD

Hello Mr. XXXXXXX Hofmeister,

Thank you for your query.

You have given an excellent and detailed description of the problem. As I understand, you are a 60 year old gentleman on treatment for hypertension with periodic cough, a lung nodule and asymptomatic fusiform dilatation of the ascending...

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My son aged 21 is having BP of 150/80. The doctor advised TMT and echo for CAD and MITRAL VALVE prolapse. He also advised olmezest 10 mg after breakfast. Is the apprehension of the doctor justifiable.

doctor1 MD

Hello,
Thank you for your query.

At 21 years of age, it is not usual to have a systolic BP of 150 mmHg. The cause for this systolic hypertension needs to be evaluated.

But, before that, it would be nice to confirm that the BP is persistently high and that multiple abnormal readings are there over...

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My mom was told by her primary care physician that half of her heart is enlarged, she has a leaky valve, and the aortic artery is bulging. He told her that her heart has probably been like this for a long time. He wants her to come back in 6 months to see if there is a change. Is this normal or should she be seen by a cardiologist??

doctor1 MD

hai,
Enlargement of heart and valve problem are not normal.it is abnormal heart condition like ventricular hypertrophy,valve prolapse.
Heart related problem can be detected by ECG and ECHO.
kindly take her to a cardiologist for better assessment and management as earlier.
thank you
hope i...

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I am an Ehlers Danlos hpermobile non vascular patient. In less than one year my aorta went from 3.0 to 3.5. My worst fear is a dissection. My question is, is sex and masturbation XXXXXXX for me? Should I stop? I haven't done anything sexual now in weeks because I'm afraid of causing a sudden dissection or tear or something. Also what can I be doing between dr appointments to stay as safe as possible from this.

doctor1 MD

Hi,
Thank you for writing in.
I am a cardiologist and will try to address your concerns.
By now, you must be aware that Ehlers-Danlos syndrome is a heterogeneous group of inherited connective-tissue disorders, out of 11types only in type IV disorder aorta is affected. (There is some overlap...

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Recent questions on  Aortic insufficiency

doctor1 MD

Hii,My cousin is having a hole in heart. Please find the summary of his check up. Doctors are advising for surgery. Which type of surgery is suiable for him? Key hole or open heart? Is it urgent to do the surgery now?SUMMARY Large secundum ASD seen in multiple views. Measures up to 2.4 cm from superior rim to inferior rim.The left ventricular size is normal.Left ventricular systolic function is normal.The right ventricle is mild to moderately dilated.The right ventricular systolic function is normal.The left atrial size is normal.The right atrium is mildly to moderately dilated.Mild atherosclerotic plaque(s) in the aortic arch.Mild atherosclerotic plaque(s) in the descending aorta.FINDINGS: LEFT VENTRICLE The left ventricular size is normal. Left ventricular systolic function is normal.RIGHT VENTRICLE The right ventricle is mild to moderately dilated. The right ventricular systolic function is normal. LEFT ATRIUM The left atrial size is normal.RIGHT ATRIUM The right atrium is mildly to moderately dilated. Large secundum ASD seen in multiple views. Measures up to 2.4 cm. A secundum type atrial septal defect is present. - AORTIC VALVE The aortic valve is trileaflet. No aortic regurgitation is present. - MITRAL VALVE The mitral valve is normal in structure and function. There is no mitral regurgitation noted. - TRICUSPID VALVE Structurally normal tricuspid valve. There is trace tricuspid regurgitation. - PULMONIC VALVE Structurally normal pulmonic valve. Trace pulmonic valvular regurgitation. - ARTERIES Mild atherosclerotic plaque(s) in the aortic arch. Mild atherosclerotic plaque(s) in the descending aorta. - VENOUS 3/4 pulmonary veins were visualized draining into the left atrium. -

doctor1 MD

i am a 25 year old male. 195 pounds 6ft. tall
just when for a run. I havent ran in a while. i experienced tightness/pulsing on right side of chest above pec below the collar bone. i could feel a very fast pulse? is there something wrong or am i out of shape?
ps i also was born with ventricular septal defect but it closed up. But i do have aortic insufficiency.

doctor1 MD

I have Aortic Regurgitation,Diabetese and mildly enlarged Prostrate Gland.I have been recommended Vetlam .4 mg night time but this medicine I am unable to tolerate mainly Blocked nose and heaviness in chest. Kindly suggest me what to do. Dr.Rakesh Kishore

doctor1 MD

can you please confirm us what would be the expenses for valve change as my mother's ecocardiography report is Rheumatic Heart Disease.

S/P PTMC(2008)

Mild Mitral Stenosis. Mild Mitral Regurgitation

Severe Valvular Aortic Stenosis. Mild Aortic Regurgitation.

Normal LV Systolic Function.

doctor1 MD

Hello My echocardiogram showed normal size of the cardiac chambers. The right ventricular function appeared to be well preserved. The doppler study showed evidence of mild mitral regurgitation and mild tricuspid regurgitation , minimal aortic...

doctor1 MD

I am a 59 yr old male with a long history of extensive vascular disease involving peripheral vessels, cerebral vessels and coronary vessels. I had a PCI in 2012 to a intermediate ramus. I have an aortic stenosis . I have a peak/mean gradient of...

doctor1 MD

What bottom number is too low for blood pressure?

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