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Do I need surgery for aortic regurgitation (AR)?

Q: I am 33 years old. I weigh 74 kg and I am 5 feet 8 inches tall. My blood pressure (BP) is 140/91. I had a near syncope last month. It was recently diagnosed that I have non-RHD eccentric AR (Grade II/IV). Normal size cardiac chambers normal global LV systolic function. Ejection fraction is 78%. Normal LV filling pattern LVEDD - 42 mm; LVESD - 23 mm. Since then I feel a little pressure in my chest and right shoulder. I have itching and watering from the right eye. How serious is the condition? Can medication cure or just delay the need of surgery? Can I do light exercise like walking? Will breathing exercise (pranayam) help to control hypertension?

A:As far as your aortic regurgitation is concerned, at this moment in time, you certainly do not need any kind of surgical intervention. In aortic regurgitation, surgical intervention is needed either when it becomes a florid leak or when the heart function begins to decline or the heart starts dilating or increasing in size - None of which is happening in your case. So I think an annual echocardiographic follow up with a cardiologist is sufficient. The leak in the valve can some times be arrested and if it stays at the level that it is currently, then it should not create much problem. However, if it increases, in that case, surgery may be required but the way things are progressing in modern days, may be in 5 years time, we would have percutaneous techniques developed so that no surgery is required for changing the valve and that should certainly help matters as far as your stress is concerned of undergoing surgery. Most certainly you can be involved in full and gainful employment and activities like walking, playing and jogging. Pranayam may not reduce the leak in the valve but it definitely helps in reducing the blood pressure and therefore is a good practice to perform Pranayam because it has multiple health benefits.


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