Aortic regurgitation Flashcards
(19 cards)
What is the definition of aortic regurgitation (AR)?
Inadequate closure of the aortic valve during diastole that results in reverse blood flow through the aortic valve.
Also known as insufficiency or incompetence.
What is the prevalence of aortic regurgitation in the UK for individuals aged over 65?
1.6%
Aortic regurgitation is the 4th most common valvular disease globally.
What factors contribute to the increased prevalence of aortic regurgitation?
- Population aging
- Availability of imaging techniques
- Migration flows
- Improvement in valve surgery
- Increase in predisposing factors of infective endocarditis
What are the causes of aortic regurgitation?
- Abnormalities of the aortic leaflets
- Abnormalities of the proximal aortic root
List some abnormalities of the aortic leaflets that can cause AR.
- Bicuspid aortic valve
- Infective endocarditis
- Rheumatic heart disease
What are some abnormalities of the proximal aortic root that can cause AR?
- Idiopathic aortic root dilation
- Marfan syndrome
- Aortic dissection
- Syphilis
- Collagen vascular disease (e.g., SLE, ankylosing spondylitis)
What is the effect of aortic regurgitation on left ventricular hypertrophy?
Hypertrophy of the left ventricle occurs due to increased ventricular workload and chamber enlargement to hold regurgitant blood.
This results from the volume overload on the left ventricle.
How does aortic regurgitation affect coronary blood flow?
Intraventricular diastolic pressure increases, compressing the heart muscle and decreasing coronary blood flow, leading to potential ischemia.
What is the pathophysiology of aortic regurgitation?
Volume overload on the left ventricle due to regurgitant volume, leading to eccentric cardiac hypertrophy, increased stroke volume, and decreased diastolic pressure.
What is heard on cardiac auscultation of AR?
Early diastolic ‘blowing’ murmur of high pitch heard maximally over the left ventricle at the 3rd to 4th ICS during diastole.
What are common symptoms of aortic regurgitation?
- Dyspnea
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Syncope
- Angina
What are signs of chronic aortic regurgitation?
- Hyperdynamic PMI (point of max impulse)
- Diastolic murmur
- Austin Flint murmur
- Corrigan’s pulse
- Hill’s sign
- Pistol-shot femoral pulse
- Duroziez’s sign
- De Musset’s sign
- Quincke’s pulse
What does a chest X-ray show in aortic regurgitation?
Cardiomegaly due to dilation of the left ventricle.
What findings can be seen in an echocardiogram for aortic regurgitation?
- Abnormal or stretched valve leaflets
- Thickening
- Vegetations
- Calcification
- Bicuspid valve
- Prolapsed or flail leaflets
What is a common diagnostic tool for assessing moderate or severe AR?
Cardiovascular magnetic resonance.
What is a common complication of untreated aortic regurgitation?
- Left ventricular hypertrophy
- Heart failure
- Arrhythmias
True or False: Aortic regurgitation is also known as aortic insufficiency.
True
Fill in the blank: Aortic regurgitation can result from congenital valve abnormalities, rheumatic fever, ________, aortic root dilatation, and degeneration of the valve due to aging.
[infective endocarditis]
What is a common clinical feature of aortic regurgitation during physical examination?
Distinctive heart murmur.
