Aortic regurgitation

Question 1

What is aortic regurgitation?

Answer 1

Incomplete closure of the aortic valve that leads to reflux of blood from the aorta into the left ventricle (LV) during diastole

Question 2

What are the causes of aortic regurgitation?

Answer 2

(Acute) Infective endocarditis
Aortic dissection
(Chronic) Congenital bicuspid valve
Rheumatic heart disease
Distortion or dilation of the ascending aorta and aortic root (i.e. , Marfan syndrome, Ehlers-Danlos syndrome, syphilis)

Question 3

What are the clinical features of aortic regurgitation? fa

Answer 3

(Acute) Sudden, severe dyspnea
Rapid cardiac decompensation secondary to heart failure
Pulmonary edema
(Chronic) Palpitations
Symptoms of left heart failure
Exertional dyspnea
Angina 
Syncope 
Symptoms of high pulse pressure (e.g., head pounding, rhythmic nodding, or bobbing of the head in synchrony with heartbeats- de Musset sign)

Question 4

How is aortic regurgitation diagnosed?

Answer 4

(Physical) Collapsing pulse 
S3 murmur 
High-pitched, blowing, decrescendo early diastolic murmur 
Austin Flint murmur 
Transthoracic echocardiogram (TTE)

Question 5

What is the treatment for aortic regurgitation?

Answer 5

(Conservative) Treatment of heart failure (i.e. beta-blockers, diuretics, ACE inhibitors, low salt diet, moderate ecercise
(Surgical) Aortic valve replacement