Aortic Regurgitation

Question 1

What is the pathology of aortic regurgitation?

Answer 1

• Regurgitation = increase in LV end-diastolic pressure
• = LV dilation and hypertrophy

Question 2

Aetiology: Aortic Regurgitation

Answer 2

• Rheumatic Fever
• Endocarditis
• Hypertension
• Atherosclerosis
• Marfan’s Syndrome
• Syphilis
• Seronegative arthritis
• Aortic Dissection

Question 3

Symptoms: Aortic Regurgitation

Answer 3

• SOB
• Arrhythmias
• Orthopnoea
• Paroxysmal Nocturnal SOB
• Angina

Question 4

Clinical Signs: Aortic Regurgitation

Answer 4

Peripheral

• Capillary nail pulsations: Quincke’s sign
• Collapsing waterhammer pulse
• Head nodding with pulse: de Musset’s sign
• Visible carotid pulsations: Corrigan’s sign

Central

• Heaving displaced apex beat
• Early diastolic high pitched murmur
  
  • Lower left sternal edge patient sit forwards
• S3

Question 5

Investigations: Aortic Regurgitation

Answer 5

Imaging

• ECG:
  
  • LV hypertrophy and strain
  • Left axis deviation
• Echo
• CXR
  
  • Cardiac enlargement
• Cardiac catheterisation

Question 6

Management: Aortic Regurgitation

Answer 6

Medical

• Diuretics, ACEi, Vasodilators
• Aimed at reducing symptoms/heart failure
• Surgery*
• Aortic valve replacement