Aortic regurgitation: what you need to know before making important decisions
Medically reviewed by
Prof. Vlad Gariboldi
Updated on
August 6, 2026
Have you been offered surgery?
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Have you been presented with several treatment options?
Have you been presented with several treatment options?
Have you been presented with several treatment options?
An expert physician will analyze your medical records and history to help you choose the most appropriate strategy for your situation, whether it be medical treatment, surgery, or monitoring.
Torn between two treatments?
Torn between two treatments?
A specialist will explain exactly what each option entails, including effectiveness, side effects, and daily impact, so you can make your decision with confidence.
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Still unsure about your diagnosis?
Still unsure about your diagnosis?
A specialist doctor will analyze your complete file (tests, imaging, medical history) to provide you with a reasoned diagnosis and guide your care.
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Have you just received a diagnosis?
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When facing cancer or a serious illness, every decision counts.
When facing cancer or a serious illness, every decision counts.
A doctor at an expert center will review your file to confirm your care plan, clarify the available options, and help you make decisions with confidence.
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
What is a medical second opinion?
What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
Your health insurance may cover your second opinion.
Your health insurance may cover your second opinion.
Many partner health insurance providers cover the Diagdoor service with no upfront costs. Check your eligibility as soon as you create your account.
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Are you looking for a second opinion for a loved one?
The process is entirely online. Upload your available medical documents, and our team will take care of the rest.
How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
Not sure if your case is eligible?
Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
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Your doctor may have detected a heart murmur during an examination, or an ultrasound may have revealed a leak in your aortic valve. This discovery naturally raises questions about how the condition progresses and the decisions that may lie ahead. Aortic regurgitation is often silent for many years; understanding how it works is the first step toward moving forward with peace of mind.
Key points
- Aortic regurgitation is a leak in the aortic valve: with every heartbeat, some blood flows back into the left ventricle (the heart chamber responsible for pumping blood to the body) instead of circulating normally.
- In its chronic form, the condition often progresses without symptoms for several years and is frequently discovered during a routine check-up.
- A Doppler echocardiogram is the gold-standard test for confirming the diagnosis, assessing severity (mild, moderate, or severe), and monitoring changes over time.
- Surgery is indicated for severe cases that are symptomatic or affecting the left ventricle; mild to moderate cases are managed through regular monitoring.
When the aortic valve leaks: mechanism and types
The aortic valve separates the left ventricle from the aorta (the large artery that distributes oxygenated blood throughout the body). In aortic regurgitation, the valve leaflets do not close tightly with each heartbeat, causing some blood to flow back into the left ventricle instead of being pumped to the body. The ventricle gradually dilates to compensate for this overload, which can mask the progression of the condition for many years.
There are two forms based on how they develop. Chronic aortic regurgitation develops over years and is often well-tolerated for a long time; this is the most common form. Acute aortic regurgitation appears suddenly, often due to infective endocarditis (an infection of the valve) or aortic dissection, and is a medical emergency that must be distinguished from chronic forms.
Main causes:
- Bicuspid aortic valve: A congenital malformation (a valve with 2 leaflets instead of 3), which is the leading cause of aortic regurgitation before age 65. When a bicuspid valve is identified, cardiology guidelines recommend screening for first-degree relatives.
- Age-related degeneration: The leading cause after age 65.
- Genetic connective tissue disorders: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome.
- Autoimmune or inflammatory diseases: Lupus, ankylosing spondylitis.
- Infective endocarditis or a history of mediastinal radiation therapy.
1 to 2%
of the population has a bicuspid aortic valve
6 to 13%
of people over 75 with significant valvular heart disease
> 50%
of chronic aortic regurgitation cases are detected without symptoms
Symptoms of aortic regurgitation: often a late onset
Chronic aortic regurgitation is characterized by a long asymptomatic phase. The left ventricle gradually adapts to the overload, which can mask the progression of the condition for several years. When symptoms do appear, they typically manifest first during physical exertion: shortness of breath, unusual fatigue, and palpitations. The onset of symptoms at rest or their rapid worsening is a warning sign that warrants a medical consultation as soon as possible.
From heart murmur to ultrasound: how the diagnosis is made
The discovery of a murmur during auscultation usually leads to a Doppler echocardiogram, the gold-standard test for confirming the diagnosis. The ultrasound allows for visualization of the leak, measurement of its severity, and assessment of its impact on the left ventricle. Grading the condition as mild, moderate, or severe relies on several cross-referenced parameters, the interpretation of which requires specialized expertise. Additional tests, such as an exercise stress test or cardiac MRI, may be necessary in certain complex situations.
Monitoring or surgery: options based on severity
There is no medication capable of correcting a valvular leak. For mild to moderate forms, regular monitoring via ultrasound is the standard of care. When aortic regurgitation becomes severe and symptomatic, or when its effects on the left ventricle reach certain thresholds, surgical intervention may be considered. The decision to operate, the choice between a mechanical or biological valve, and the possibility of a conservative repair (repairing rather than replacing the valve) are individualized decisions discussed with the medical-surgical team.
Second opinions and aortic regurgitation: when should you seek one?
Aortic regurgitation is a condition where several key decisions may arise over time: confirming the diagnosis and its severity, determining the right time for intervention, and choosing the type of valve prosthesis best suited to your personal situation. A second opinion from a cardiologist specializing in valvular heart disease can be invaluable for reviewing your entire file and moving toward an informed decision. Diagdoor allows you to obtain this specialized opinion in less than 7 days, with potential coverage by your health insurance or supplemental plan, with no upfront costs.
Frequently Asked Questions
What is the difference between aortic regurgitation and aortic stenosis?
Aortic stenosis is a narrowing of the valve that restricts blood flow to the aorta. Aortic regurgitation is a leak that allows blood to flow back into the left ventricle: two distinct mechanisms with different progressions and treatments.
Is aortic regurgitation serious if I don't have any symptoms?
Asymptomatic aortic regurgitation can remain stable for many years with regular monitoring. The severity depends on the extent of the leakage and its impact on the left ventricle, which are assessed via echocardiography.
Can I live a normal life with aortic regurgitation?
In mild to moderate cases, daily life is generally not affected. Regular cardiological follow-ups are necessary to adjust management if the condition progresses.
When is surgery required for aortic regurgitation?
The decision to operate is based on several combined criteria: the onset of symptoms, dilation of the left ventricle, and a decrease in the ejection fraction (the heart's ability to pump blood). This decision is personalized and discussed with a specialized team.
Can aortic regurgitation get worse?
Yes, aortic regurgitation can progress, particularly if there is an underlying progressive cause or aggravating factors such as high blood pressure. Regular follow-up with echocardiography allows for the detection of any changes and the adjustment of treatment accordingly.
Need the opinion of a
cardiac surgeon
Upload your file to Diagdoor. A
cardiac surgeon
specialist
of valvular heart diseases
analyzes it and provides a reasoned opinion in less than 7 days.
Sources
- French Society of Cardiology (SFCardio), Chapter 08 – Item 233: Valvular Heart Diseases
- Santé Publique France / BEH, Hospitalizations for valvular heart disease in France, 2020
- Bordeaux University Hospital, Aortic Regurgitation
- Center for Rare Vascular Diseases, Familial Aortic Bicuspid Valve
Further Reading
Why get a second opinion?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
How does it work?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
Did you know?
Have you been offered surgery?
Have you been offered surgery?
Surgery is never trivial. A medical specialist will analyze your file to confirm the recommendation or explore other therapeutic options.
Is there an alternative to surgery?
Is there an alternative to surgery?
A surgeon specializing in your condition will re-evaluate your file to confirm if surgery is necessary or to identify less invasive solutions.
Have you been presented with several treatment options?
Have you been presented with several treatment options?
Have you been presented with several treatment options?
An expert physician will analyze your medical records and history to help you choose the most appropriate strategy for your situation, whether it be medical treatment, surgery, or monitoring.
Torn between two treatments?
Torn between two treatments?
A specialist will explain exactly what each option entails, including effectiveness, side effects, and daily impact, so you can make your decision with confidence.
Still unsure about your diagnosis?
Still unsure about your diagnosis?
Still unsure about your diagnosis?
A specialist doctor will analyze your complete file (tests, imaging, medical history) to provide you with a reasoned diagnosis and guide your care.
Have you just received a diagnosis?
Have you just received a diagnosis?
Have you just received a diagnosis?
Have your medical file reviewed by a specialist in your condition. You will receive an additional opinion in less than 7 days, helping you move forward with clarity.
Is your condition rare or complex?
Is your condition rare or complex?
Diagdoor gives you access to a doctor who specializes in your condition to confirm your treatment plan, no matter where you live.
When facing cancer or a serious illness, every decision counts.
When facing cancer or a serious illness, every decision counts.
A doctor at an expert center will review your file to confirm your care plan, clarify the available options, and help you make decisions with confidence.
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
What is a medical second opinion?
What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
Your health insurance may cover your second opinion.
Your health insurance may cover your second opinion.
Many partner health insurance providers cover the Diagdoor service with no upfront costs. Check your eligibility as soon as you create your account.
Are you looking for a second opinion for a loved one?
Are you looking for a second opinion for a loved one?
The process is entirely online. Upload your available medical documents, and our team will take care of the rest.
How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
Not sure if your case is eligible?
Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
Need the opinion of a
cardiac surgeon
Need the opinion of a
cardiac surgeon
Upload your file to Diagdoor. A
cardiac surgeon
specialist
of valvular heart diseases
analyzes it and provides a reasoned opinion in less than 7 days.