Aortic regurgitation

Question 1

What causes Aortic regurgitation

Answer 1

Chronic causes:
1) Aortic root disease/dilation

• Rheumatic Heart disease, usually along with Mitral disease.
• Infective endocarditis
• Senile/degenerative calcification (but regurgitation is less common than stenosis in these cases)
• Aortic dissection
• Congenital causes: Marfans,

Acute causes:
Infective endocarditis
Post MI papillary muscle damage or rupture
Blunt chest trauma

Question 2

Pulse in Aortic regurgitation

Answer 2

Waterhammer pulse
Corrigans carotid pulsation
Head nodding with each pulse

Question 3

Signs of aortic regurgitation

Answer 3

Waterhammer pulse
Corrigans carotid pulsation
De Musset's head bobbing
Mullers - Uvula pulsation
Traubes Loud ass femoral arteries
Quincke Capillary pulsation of nail beds
Duroziez- femoral artery murmur

Question 4

Aortic regurgitation auscultation

Answer 4

High pitched, Long, Blowing early diastolic decresendo

Loudest when leaning forward and exhaling

Question 5

Prognosis of Aortic regurgitation

Answer 5

Acute, needs immediate valve replacement or death.

Chronic, well tolerated.
75% 5 year survival
50% 10 year survival

Surgery is indicated when Congestive heart failure symptoms begin to arise.
OR
In asymptomatic patients with EF below 50%
OR
asymptomatic with severe LV dilation, EDD more than 75mm