Aortic Regurgitation Flashcards
1
Q
What are acute causes of AR?
A
Infective endocarditis
Type A aortic dissection
2
Q
What are chronic causes of AR?
A
Congenital bicuspid valve RHD Marfan's Ehlers-Danlos syndrome Ankylosing spondylitis RA
3
Q
Symptoms of AR?
A
LVF: PND, orthopnoea, dyspnoea
Arrhythmias: palpitations
Angina
4
Q
Signs of AR?
A
Collapsing pulse
Wide PP
Soft/absent A2
Signs of LVF
Displaced apex beat (due to volume overload)
Corrigan’s sign (carotids)
De Musset’s head throbbing
Quincke’s sign (capillary pulsation in nail beds)
Austin-Flint murmur (MDM over apex beat due to regurgitant jet fluttering the anterior mitral valve cusp)
5
Q
Clinical signs of severe AR?
A
Wide PP and collapsing pulse S3 Long murmur Austin Flint murmur Signs of decompensation = LVF signs
6
Q
AR investigations?
A
Bloods ECG CXR ECHO Cardiac catheterisation
7
Q
What to look for on ECG as a sign of LVH?
A
R5 > 35mm
R6 + S1 > 35mm
8
Q
What to look for on ECHO of AR?
A
- Aortic valve structure and morphology
- Evidence of IE vegetations
- Jet width (>65% outflow tract = severe), regurgitant jet volume, premature closing of mitral valve
- LV function (EF, end-systolic volume)
9
Q
Treatment of AR?
A
Medical optimisation (reduce systolic hypertension) etc. Surgical intervention required if symptomatic AF with signs of LVF or reduced EF < 50%
