Heart Murmur in the Aorta

QUESTION: Recently, after many years without medical care, I visited a
physician who discovered a heart murmur in my aorta. He was very patient with
me and tried to describe my condition, but the only term I remember is
"regurgitation"; but doesn't that apply to vomiting? Do you have enough
information to tell me what is wrong?
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ANSWER: It is always hard to concentrate when the anxiety of a new and
unexpected diagnosis disturbs our thinking. But you have given me more than
enough clues to your condition for me to discuss it. It is a disease called
aortic regurgitation (AR), sometimes called aortic incompetence or
insufficiency, which affects the aortic valves that separate the left
ventricle of the heart from the main body artery, the aorta. These valves are
responsible for keeping the blood flowing in the right direction, from the
heart to the body. However, when they become diseased they no longer close
completely, and allow some blood to flow backward into the left ventricle,
thus the term "regurgitation". In adults, the commonest cause of mild AR are
a two leafed (or bicuspid) valve where normally there are three valves, or
severe hypertension. It may also be found associated with ankylosing
spondylitis and other forms of arthritis. The murmur your physician heard was
caused by the blood flowing backward for an instant, right after your heart
has contracted. Treatment will depend upon your symptoms. Frequently they
are minimal, but you may become breathless on exertion or develop heart
palpitations. If the symptoms of heart failure develop, surgically replacing
the damaged valves is currently the treatment of choice. Since your physician
seems concerned and knowledgeable, I am sure you will be able to discuss all
of this with him again, particularly the appropriate treatment in your case.