Aortic Regurgitation

Question 1

What are the causes of aortic regurgitation

Answer 1

Acute:-
Infective endocarditis
Aortic dissection
Trauma

Chronic:-
Bicuspid aortic valve
Rheumatic fever
Connective tissue disorders - Marfans, Ehlers Danlos
Hypertension
Aortitis - Reiter’s, ankylosing spodylitis, RA, syphilis

Question 2

Which causes of AR are due to aortic root disease

Answer 2

Marfan syndrome
Aortic dissection
Trauma
Aortitis

Question 3

Which causes of AR are due to valve disease

Answer 3

Rheumatic fever
Infective endocarditis
RA

Question 4

What medications are given in chronic AR

Answer 4

ACE-i

ARBs

Question 5

What are the indications for surgery in AR

Answer 5

Wide pulse pressure - over 100
ECG changes
LV enlargement over 5.5cm systolic diameter or EF less than 50%

Symptomatic

Question 6

What is an Austin Flint murmur

Answer 6

Rumbling diastolic murmur
Due to blood flow across narrowed mitral orifice (increased LV diastolic pressure causes preamature closure of mitral valve)

Question 7

What are some causes of a collapsing pulse

Answer 7

AR
Pregnancy
Patent ductus arteriosus
Paget's disease
Anaemia
Thyrotoxicosis

Question 8

What are the eponymous signs of AR

Answer 8

Corrigan's - visible neck pulsation
Quincke's - nail bed capillary pulsation
De Musset's - head nodding
Muller's - uvula pulsation
Traube's - 'pistol shot' sound over femorals