Aortic Regurgitation Or Insufficiency (AR Or AI)

Etiology

  • Bicuspid valve
  • 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

Symptoms

  • Chronic regurg leads to slow development sx
  • Acute regurg→ acute sx

Physical Exam Findings

  • 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

Tests

Links