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Structural Heart Disease

Aortic Regurgitation



    • Causes of Aortic Regurgitation

    • Acute

    • Infective endocarditis
    • Dissecting aneurysm
    • Hypertension
    • Trauma
    • Chronic

    • Rheumatic heart disease
    • Congenital bicuspid aortic valve
    • Ankylosing spondylitis
    • Marfan syndrome / Ehlers-Danlos syndrome
    • Aortitis


  • Aortic regurgitation manifests as a descrescendo diastolic murmur, heard loudest on sitting forward on expiration.
    • Signs of Aortic Regurgitation

    • Peripheral Signs

    • Collapsing Pulse
    • Widened Pulse Pressure
    • Central Signs

    • Soft A2 - loss of normal splitting of S2 on inspiration
    • Volume-loaded apex beat - displaced apex with forceful, non-sustained impulses
    • Decrescendo diastolic murmur loudest on sitting forward, in expiration
    • Signs of Complications

    • Evidence of left ventricular failure - pulsus alternans, pulmonary crepitations
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