Table 13. Stages of Chronic AR
Stage Definition Valve Anatomy
A At risk of AR • Bicuspid aortic valve (or other
congenital valve anomaly)
• Aortic valve sclerosis
• Diseases of the aortic sinuses or
ascending aorta
• History of rheumatic fever or known
rheumatic heart disease
• IE
B Progressive AR • Mild-to-moderate calcification of a
trileaflet valve, bicuspid aortic valve
(or other congenital valve anomaly)
• Dilated aortic sinuses
• Rheumatic valve changes
• Previous IE
C Asymptomatic severe AR • Calcific aortic valve disease
• Bicuspid valve (or other
congenital abnormality)
• Dilated aortic sinuses or
ascending aorta
• Rheumatic valve changes
• IE with abnormal leaflet closure or
perforation
D Symptomatic severe AR • Calcific valve disease
• Bicuspid valve (or other
congenital abnormality)
• Dilated aortic sinuses or
ascending aorta
• Rheumatic valve changes
• Previous IE with abnormal leaflet
closure or perforation
Aortic Regurgitation
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