EXAM #1: AORTIC VALVE DISEASE Flashcards
What is aortic regurgitation?
Backflow of blood from the aorta into LV during diastole
What causes aortic regurgitation?
1) Aortic root dilation
2) Valve damage
What are the valvular defects that can cause aortic regurgitation?
1) Bicuspid aortic valve
2) Degeneration with age
3) Rheumatic fever
4) Endocarditis
5) Degeneration of prosthetic valve
What causes aortic root dilation?
1) Trauma
2) Marfan’s Syndrome
*Also syphilitc aneurysm and aortic dissection
How does aortic regurgitation present?
- Bounding pulse
- Pulsating nail bed
- Head bobbing
- S3
- Ejection click
Explain the hemodyamic changes seen in aortic regurgitation?
- In diastole, blood flow from aorta into LV–>decrease diastolic BP
- In systole, increased LV volume–>increased systolic BP
*Thus, the patient will have a widened pulse pressure
How old are patients when aortic regurgitation presents?
4th to 5th decade of life
What is the first symptom of aortic regurgitation?
Dyspnea secondary to HF
Describe the murmur seen in aortic regurgitation.
- Diastolic decrescendo “blowing”
- 2nd RICS
- Sitting forward
- Full expiration
The longer the murmur worse the regurgitation
What is an Austin-Flint murmur?
Mid-to-late diastolic rumble of functional MS
*Blood from the aorta flowing into the LV is impairing the mitral valve
What is the utility of echo in AR?
1) Determining the etiology
2) Evaluating LV function
Most of the time, what is associated with AR?
Aortic stenosis
What is the goal of medical therapy in AR?
Reduce afterload/ diastolic pressure with:
- ACE inhibitors
What is the definitive treatment for AR?
Valve replacement
What is the most common cause of aortic stenosis?
Fibrosis and calcification that occurs with “wear and tear” during life
