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Aortic Regurgitation - Etiology
Aortic regurgitation can result from abnormalities of the aortic valve leaflets, dilation of the aortic root, or a severe increase in afterload.
When the aortic leaflets are involved, there is frequently a destructive process occurring such as infective endocarditis or rheumatic valvular disease. Any disease process that results in dilation of the aortic root will cause the aortic valve annulus to stretch resulting in failure of the leaflets to coapt properly in diastole. Aortic regurgitation results. Frequently, repair of the aortic root as well as the valve required in this scenario.
A list of etiologies of aortic regurgitation is below:
Aortic leaflet/cusp abnormalities
Infectious: Bacterial endocarditis, rheumatic fever
Congenital: Bicuspid aortic valve calcification
Inflammatory: SLE, RA, Behcet's syndrome
Degenerative: Myxomatous (floppy valve), senile calcification
Others: Trauma, post aortic valve valvuloplasty, diet drugs
Aortic root abnormalities
Aortic root dilation: Marfan's syndrome, syphilitic aortitis,
idiopathic aortitis, Ehlers-Danlos syndrome, relapsing polychondritis
Loss of commissural support: aortic dissection, trauma,
ventricular septal defect (VSD)
Increased afterload
Uncontrolled systemic hypertension
Supravalvular aortic stenosis
Coarctation of the aorta