- Aortic aneurysm from Marfans/connective tissue d/o, idiopathic, large vessel vasculitis (e.g. Takayasus, Behcets), tertiary syphilis
- Rheumatic heart dz
- Aortic root dilatation from hypertension
- Acute regurgitation from endocarditis or aortic dissection
- Chronic regurg leads to slow development sx
- Acute regurg→ acute sx
- Decrescendo diastolic murmur, loudest along L sternal border
- Accentuated by sitting up and leaning forward
- Carotid pulse can be bounding (large stroke volumes)
- Prominent peripheral arterial pulses
- Wide pulse pressure w/chronic dz (DBP less than 50% of SBP)
- Other findings CHF w/advanced disease
- Acute AI may have minimal murmur, normal pulse pressure
- Echo very helpful in identifying cause, determining degree of regurgitation, LV end diastolic volume and systolic function