Aortic Regurgitation

Question 1

classification of AR

Answer 1

chronic or acute

Question 2

usual cause of acute severe AR

Answer 2

IE or aortic dissection

Question 3

MCC of chronic severe AR (5)

Answer 3

1. dilated ascending aorta from HTN
2. dilated ascending aorta from primary aortic disease
3. calcific AS
4. bicuspid aortic valve
5. rheumatic dz

Question 4

sxs in chronic severe AR

Answer 4

• angina
• orthopnea
• exertional dyspnea

Question 5

pulse pressure in chronic severe AR

Answer 5

widened pulse pressure

Question 6

heart sounds in chronic severe AR

Answer 6

• soft S1
• soft or absent A2
• loud S3

Question 7

heart murmurs in chronic severe AR

Answer 7

• DIASTOLIC murmur immediately after A2 along LSB (primary aortic valvular dz) or RSB (secondary to aortic root dilatation)

Question 8

enhanced auscultation when?

Answer 8

• leaning forward

- exhaling

Question 9

ECG findings in chronic severe AR

Answer 9

• LAD

- LVH

Question 10

CXR findings in chronic severe AR

Answer 10

• cardiomegaly

- aortic root dilatation and calcification

Question 11

murmur heard in acute AR

Answer 11

short, soft, sometimes inaudible diastolic murmur

Question 12

severe acute AR causes what to happen to the mitral valve?

Answer 12

EARLY closure

Question 13

what can echo show in severe acute AR?

Answer 13

diastolic aortic flow reversal

Question 14

tx for pts w/ acute AR

Answer 14

immediate aortic valve replacement

Question 15

bridging tx for acute AR

Answer 15

nitroprusside and IV diuretics

Question 16

tx for AR if BP too low

Answer 16

dobutamine or milrinone