 The free margins of valve cusps no longer approximate leading to aortic valve insufficiency.As blood regurgitates into the left ventricle between each systole, volume overload ensues and the ventricular wall hypertrophies in an attempt to maintain cardiac output and blood pressure.The massive ventricle can lead to a heart weighing over 1000 grams (the weight of a normal heart is about 350 grams), referred to as "cor bovinum" (Latin for cow's heart).