Aortic Regurgitation

Question 1

What are the causes of aortic regurgitation? (8)

Answer 1

1. Rheumatic heart disease
2. Infective endocarditis
3. Bicuspid valve
4. HTN
5. Aortic dissection
6. Marfan’s
7. Rheumatoid arthritis
8. Ankylosing spondylitis

Question 2

What is the nature of an aortic regurgitation murmur?

Answer 2

Early diastolic, high pitched (breath-like)
Loudest left lower sternal edge
Sitting forward, breath held in expiration

Question 3

What are the features associated with an aortic regurgitation murmur? (8)

Answer 3

1. S3
2. Thrusting, displaced apex
3. Collapsing pulse
4. Corrigan’s sign
5. Quinke’s - nail bed pulsation
6. De Musset’s - head nodding
7. Austin-flint murmur

Question 4

What are the differentials for an aortic regurgitation murmur?

Answer 4

1. Pulmonary regurgitation
2. Graham steele murmur - pulomnary valve incompetence due to pulmonary hypertension