Harvard Heart Letter

Ask the doctor: Do I really need surgery to fix my aortic valve?

Q. I have had a leaking aortic valve for many years. I get an echocardiogram every six months. After the latest one, my doctor told me that my heart was enlarging and asked me repeatedly whether I was getting short of breath with exercise. I told him that sure, I get tired, but it isn't like I am breathing hard while sitting still. Now he wants me to have surgery to replace the valve. Should I do this at age 68?

A. You have been getting exactly the right attention for what is called aortic regurgitation. This is the backflow of some blood into your left ventricle with each heartbeat, instead of it all going into your aorta.

Doctors usually don't like to replace an aortic valve until a person is beginning to be limited by symptoms such as shortness of breath. That is why your physician was pressing you so hard about such symptoms after your recent echocardiogram. But it can be hard to tell whether an individual's shortness of breath with exercise represents being out of shape or is a symptom that reflects the severity of a valve problem.

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