Aortic regurgitation Flashcards
define aortic regurgitation?
reflux of blood from the aorta into the left ventricle during diastole. Also known as aortic insufficiency
valvular causes of aortic regurgitation?
o Bicuspid aortic valve
o Infective endocarditis
o Rheumatic fever
o Trauma
aortic root causes of aortic regurgitation?
o Systemic hypertension o Aortic dissection o Ankylosing spondylitis o Arthritides (joint inflammation) o Connective tissue disease (e.g. Marfan's, Ehlers-Danlos) o Syphilis
epidemiology of aortic regurgitation?
• It is most frequently seen in patients > 80 yrs
presenting symptoms of aortic regurgitation?
o Initially ASYMPTOMATIC
o Later on, the patient may develop symptoms of heart failure
key features of aortic regurgitation murmur?
• Early diastolic murmur: crescendo di crescendo, high pitched and blowing in character.
where is an aortic regurgitation murmur best heard?
• Can be heard on the left sternal border when patient is leaning forward on end expiration.
what is the austin flint murmur?
mid-diastolic murmur heard in severe AR.
o Due to the partial closure of the anterior mitral valve cusps caused by regurgitation streams.
what are signs associated with aortic regurgitation murmur?
• Collapsing pulse
• Thrusting and heaving displaced apex beat
• Intensity of the murmur is increased by the handgrip manoeuvre.
o Quincke’s Sign - visible pulsation on nail bed
o de Musset’s Sign - head nodding in time with the pulse
o Corrigan’s Sign - visible pulsation in the neck
what might one see on chest x-ray of someone with an aortic regurgitation murmur?
o Cardiomegaly
o Dilatation of ascending aorta
o Signs of pulmonary oedema
why might an echo be helpful?
o May show underlying cause (e.g. aortic root dilatation, bicuspid aortic valve)
o May show the effects of aortic regurgitation (e.g. left ventricular dilatation, fluttering of the anterior mitral valve leaflet)
