Cardiac Valve Defects - Aortic Regurgitation

Question 1

Aetiology of Aortic Regurgitation (4).

Answer 1

1. Idiopathic Age-Related Weakness.
2. Connective Tissue Disorders.
3. Valve Disease - Rheumatic, IE, Bicuspid.
4. Aortic Dissection, Spondyloarthropathy, Hypertension, Syphilis.

Question 2

Nature of Murmur in Aortic Regurgitation (4).

Answer 2

1. Early Diastolic.
2. Soft.
3. Heard best in aortic area.
4. Soft S1.

Question 3

Clinical Signs with Aortic Regurgitation (5).

Answer 3

1. Corrigan’s - Collapsing Pulse (Waterhammer Pulse).
2. Austin-Flint Murmur.
3. Wide Pulse Pressure.
4. Quincke’s Sign (Nailed Pulsation).
5. De Musset’s Sign (Head Bobbing).

Question 4

What is an Austin-Flint Murmur?

Answer 4

An early/mid diastolic rumbling murmur heard at the apex, caused by blood flowing back through the aortic valve and mitral valve causing it to vibrate.

Question 5

Clinical Presentation of Acute Aortic Regurgitation (5).

Answer 5

1. Sudden Cardiovascular Collapse.
2. Pulmonary Oedema.
3. Pallor.
4. Sweating.
5. Peripheral Vasoconstriction.

Question 6

Clinical Presentation of Chronic Aortic Regurgitation (4).

Answer 6

1. Exertion Dyspnoea.
2. Orthopnoea.
3. Paroxysmal Nocturnal Dyspnoea.
4. Stable Angina (Reduction in Diastolic Coronary Perfusion).

Question 7

Investigations of Aortic Regurgitation (3).

Answer 7

1. Definitive : Echocardiogram.
2. Cardiac MRI : Moderate/Severe (2nd Line).
3. Invasive Cardiac Catheterisation and Angiography.

Question 8

Indications for Surgical Intervention of Aortic Regurgitation (3).

Answer 8

1. Significant Enlargement of Ascending Aorta.
2. Symptomatic.
3. Infective Endocarditis.

Question 9

Why does Aortic Regurgitation result in Heart Failure?

Answer 9

Back pressure of blood waiting to get through the left side of the heart.