Aortic Regurgitation

Question 1

Pathophysiology

Answer 1

Failure of aortic valve to open completely leading to backflow of blood

Question 2

Causes

Answer 2

Aortic root dilation
Aortic dissection
Aortic aneurysm
Bicuspid Aortic valve
Infective endocarditis
Rheumatic Fever
RA/SLE
Marfans/ EDS
Calcification

Question 3

Symptoms

Answer 3

Most asymptomatic
Dyspnoea
Reduced exercise tolerance

Question 4

Examination of pulse finding

Answer 4

Bounding pulse
Wide pulse pressure
Collapsing Pulse

Question 5

Examination auscultation findings

Answer 5

Early diastolic blowing murmur loudest in pulmonary area (2nd IC Left)
Exacerbated by hand gripping manouvre (30s)

Question 6

Special examination findings

Answer 6

Quinkes sign
Head bopping

Question 7

Cause examination findings

Answer 7

Tall thin build
Long extremeties
Mallar rash
Reumatoid nodules
poor dental hygeine
Rash

Question 8

Complication examination findings

Answer 8

Displaced apex beat
Bibasal crackles
Sacral odema
peripheral odema

Question 9

Treatment

Answer 9

Ace inhibitors to reduce afterload (Severe/LVD)
Surgery

Question 10

Indications for surgery

Answer 10

Symptomatic sever AR
Asymptomatic severe with LVD
Asymptomatic with aortic root dilation >5.5cm (4.5cm for marfans/Bicuspid valve)