What is the typical presentation of aortic regurgitation?

The typical presentation of aortic regurgitation involves a long asymptomatic period, which can last for many years. This occurs because the body can initially compensate for the volume overload on the left ventricle caused by the regurgitant flow from the aorta back into the left ventricle during diastole. As the condition progresses, patients may begin to experience symptoms such as exercise intolerance and dyspnea at rest due to the reduced cardiac output and eventual heart failure.

During this progression, patients might initially tolerate normal activities without significant symptoms. However, as ventricular dilation and hypertrophy develop, they may become symptomatic, particularly with exertion. This combination of prolonged asymptomatic phases followed by worsening symptoms accurately characterizes the clinical picture associated with aortic regurgitation. The symptoms reflect the heart's inability to maintain adequate output in the face of increased volume overload and decreased contractility over time.