Aortic regurge

Question 1

Presentation

Answer 1

-Large volume, collapsing pulse
- Displaced, thrusting apex
- end diastolic murmur at the left sternal edge, loudest with the patient sitting forward

Question 2

Causes

Answer 2

• bicuspid aortic valve
• HTN
• Rhuematic fever
• Aortitis
• RA/SLE
• Connective tissue disorders

Question 3

Acute AR

Answer 3

aortic dissection, IE

Question 4

Severe AR

Answer 4

wide pulse pressure, long duration of murmur, third heart sound, pulmonary HTN, LVF

Question 5

Eponymous signs

Answer 5

Corrigan’s - visible carotid pulsations in the neck
Quinke’s - capillary pulsations
De Musset’s - head nodding
Muller’s - pulsing of the uvula

Question 6

Medical management

Answer 6

reduce systolic BP - nifedipine and ACEi

Question 7

Valve replacement indications

Answer 7

SYMPTOMATIC - +symptoms of HF or angina
ASYMPTOMATIC - LVSD, LV dilatation, aortic root dilatation