What Causes Aortic Incompetence?

Reviewed on 9/9/2022
Person holding a heart figure
Aortic incompetence has many causes, including aging, high blood pressure (hypertension), congenital heart valve disease, aortic stenosis, infective endocarditis (bacterial endocarditis), rheumatic fever or rheumatic heart disease, Marfan syndrome, lupus, trauma, and untreated syphilis.

Aortic incompetence, also called aortic regurgitation, aortic insufficiency, or a leaky aortic valve, is a condition in which some of the blood that was pumped out of the left ventricle (the bottom left portion of the heart, considered the main chamber of the heart) leaks back in when the left ventricle relaxes. 

This results in the need for the left ventricle to work harder to push blood through the aortic valve, which can cause the heart to eventually enlarge and weaken and lead to heart failure

Common causes of aortic incompetence include: 

  • Aging
  • High blood pressure (hypertension)
  • Congenital heart valve disease 
    • Conditions present from birth that affect the aortic valve's structure or number of flaps of tissue between the heart’s chambers (leaflets)
  • Aortic stenosis
    • The aortic valve narrows due to calcium buildup, preventing it from opening and closing normally
  • Infective endocarditis (bacterial endocarditis)
    • An infection causes the heart chamber's lining and valves become inflamed
    • Can be life-threatening 
  • Rheumatic fever or rheumatic heart disease
    • A rare complication of strep throat 
    • Causes the aortic valve to stiffen and narrow 
  • Marfan syndrome and lupus 
    • Increased risk of an enlarged aorta
  • Trauma
    • A physical injury can result in structural changes to the aortic valve 
  • Untreated syphilis

What Are Symptoms of Aortic Incompetence?

Mild aortic incompetence (aortic regurgitation, aortic insufficiency, or a leaky aortic valve) may not cause many symptoms.

Symptoms of more severe aortic incompetence may include: 

How Is Aortic Incompetence Diagnosed?

Aortic incompetence (aortic regurgitation, aortic insufficiency, or a leaky aortic valve) is diagnosed with a patient history and physical examination. If aortic incompetence is suspected, testing may include: 

What Is the Treatment for Aortic Incompetence?

Mild aortic incompetence (aortic regurgitation, aortic insufficiency, or a leaky aortic valve) may sometimes be treated with lifestyle changes and medications to reduce blood clots and the risk of stroke, but surgery is frequently needed.

Procedures to treat aortic incompetence include: 

  • Aortic valve repair or replacement surgery
    • An open-chest procedure to repair the valve
  • Paravalvular leak closure
    • A nonsurgical procedure to repair a previously-replaced aortic valve that is now leaking

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Reviewed on 9/9/2022

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