Chronic Aortic Regurgitation : The aetiological factors leading to aortic regurgitation are: (1) rheumatic, (2) annulo aortic ectasia, (3) native valve endocarditis, (4) congenital aortic valve disease, (5) floppy aortic valve with myxomatous degeneration. Prolapse of a cusp associated with VSD, (6) iatrogenic aortic valve problem, (7) syphilitic or atherosclerotic ascending aortic aneurysm, (8) aortitis in rheumatoid arthritis, ankylosing spondylitis and Reiter's disease, (9) closed chest injury or spontaneous cusp rupture, and (10) Giant cell aortitis and Takayasu's disease.
The asymptomatic phase is longer in aortic regurgitation when compared to aortic stenosis. The volume overload is compensated for a long period by compensatory hypertrophy to maintain normal ejection. The patients are asymptomatic in this compensated phase and left ventricular function is maintained. In the decompensate stage, the patients develop dyspnoea as left ventricular function becomes impaired. Left ventricular impairment is reversible in the early stages. Aortic valve replacement done at this stage will result in full recovery of left ventricular size and function. But if the ventricle develops progressive dilatation and reduced systolic function, immediate and late results of surgery become worse.