Aortic Regurgitation by blonder - SRS

Question 1

What kind of problem is aortic regurg?

Answer 1

Volume problem, like MR

Question 2

How do patients tolerate AR?

Answer 2

PRetty well, most patients with AR remain compensated for life.

Question 3

When is a patient with AR in trouble?

Answer 3

If the LV dilates, and EF decreases, patient is in trouble

Question 4

What should you do when and AR patient gets LV dilation and EF decreases?

Answer 4

Intense med Rx as a bridge to AVR (aortic valve replacement)

Question 5

Aortic regurgitation can arise due to valvular disease. What are six etiologies associated with this progression?

Answer 5

• 1. RF (rheumatic fever)
• 2. Senile AV
• 3. IE (infective endocarditis)
• 4. Trauma (severe)
• 5. Myxomatous degeneration (marfans, ehlers danlos, ankylosing spondylitis)
• 6. Degeneration of a Bioprosthetic AVR

Question 6

Apart from valvular disease, aortic root dilation is another big cause of aortic regurgitation. What are seven etiologies associated with this progression?

Answer 6

1. Marfans, can also involve the leaflets
2. Dissecting AA
3. Non dissecting AA
4. Ankylosing Spondylitis
5. Becet’s, syphilis (syphilitic aortitis),
6. Osteogenesis Imperfecta,
7. Psoriatic Arthritis, etc

Question 7

What are you going to see on physical exam on a patient who has aortic regurgitation?

Answer 7

1. Bounding pulse, large pressure-pulse and pulse-pressure lead to many signs like Demecet’s, Traub’s, Quinke pulse, etc
2. Early diastolic decresendo murmur, LSB, 4-5th ICS, or RSB in AA