Aortic reguritation

Question 1

What is the definition?

Answer 1

Incomplete aortic valve causing regurgitate flow of blood in diastole

Question 2

What is the aetiology?

Answer 2

Split into the primary disease of aortic leaflets or aortic root dilation

Aorta:

• connective tissue disorder (hypertension)
• Dilated aorta 50%
• Aortatitis

Leaflets: 
Bicuspid AV (congenital) 
Infective endocarditis 
Rheumatic heart disease
Myxomatous degeneration 
Degenerative

Question 3

What are the acute and chronic clinical symptoms?

Answer 3

Acute: 
-Sudden dyspnoea 
- Poorly tolerated as wall tension cannot adapt
Chronic: 
-Long asymptomatic phase 
-compensation
-Exertional breathlessness 

Generally all=

• Angina
• Dyspnoea
• Syncope
• Palpitations
• Heart failure

Question 4

What are the signs/ + clinical examinations?

Answer 4

Pulse = Large volume + collapsing (fast rising)
Wide pulse pressure (distance between systolic and diastolic )
Displaced apex beat

Question 5

What are the auscultation results?

Answer 5

Lub Taaaaaaaar

Early diastolic murmur
Decrescendo

Question 6

What are the investigations involved?

Answer 6

ECG:

• ST/T changes
• LA dilation
• LV hypertrophy

CXR:
-Cardiomegaly in chronic AR

Echocardiograph

• demonstrate AV cusp anatomy
• LV function, dilation and hypertrophy

FBC

• clotting
• cholestrol

Question 7

What is the treatment?

Answer 7

Vasodilator therapy - delay timing for surgery

Aortic valve replacement or repair