How can clinicians reduce the risk of and manage severe aortic valve regurgitation manifesting as cardiogenic shock?

Introduction: Severe aortic regurgitation is a progressive condition that can lead to cardiogenic shock, a life-threatening emergency associated with high morbidity and mortality.

Areas covered: This article provides an updated review on how clinicians can diagnose, prevent, and manage aortic regurgitation presenting as cardiogenic shock, as well as discusses emerging technologies that have transformed the management of this condition.

Expert opinion: Clinicians can reduce the risk of aortic regurgitation manifesting as cardiogenic shock through a combination of early diagnosis, vigilant monitoring, optimized medical management, and timely intervention. Advanced imaging modalities, such as echocardiography and computed cardiac tomography, are essential for assessing valve function and identifying high-risk patients before decompensation occurs. For patients at risk, early referral to a multidisciplinary Heart Team is crucial for determining the optimal intervention, whether surgical or transcatheter. Future advancements in transcatheter therapies, including dedicated devices for aortic valve replacement, hold promise for expanding treatment options for high-risk patients.