Pathogenesis
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
Diagnosis
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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