Aortic Regurgitation

Question 1

Aortic Regurgitation Aetiology

Answer 1

• Bicuspid valve
• Rheumatic disease (most common cause)
• Infective endocarditis
• Collagen vascular disease
• Degenerative aortic valve disease
• Common after transcatheter aortic valve replacement
• Can occur in SLE, Marfan’s, ED

Question 2

Aortic Regurgitation Presentation

Answer 2

• Often asymptomatic and non-specific
• Can be asymptomatic with preserved systolic, asymptomatic with depressed systolic function and symptomatic
• Diastolic murmur
• Exaggerated pulsations
• High systolic pressure and low diastolic pressure (more blood in ventricle during systole, blood goes back in during diastole)

Question 3

Aortic Regurgitation Murmur

Answer 3

-Best heard with patient sitting forward in expiration

Question 4

Aortic Regurgitation Ix

Answer 4

• Echo
• ECG
• CXR
• If patient has Marfan’s evaluate aorta with MRI

Question 5

Aortic Regurgitation Management

Answer 5

• If severe, urgent surgical
• Mild-moderate can be reviewed on a yearly basis and echo every two years
• Medicate until time for surgery
• ACEi, vasodilators, inotropic agents
• Surgery if symptomatic, or LVF deteriorates
• Valve replacement

Question 6

Aortic Regurgitation Prognosis

Answer 6

-Poor prognosis without intervention