Flashcards in Aortic Regurgitation Deck (16)
What is aortic regurgitation?
Reflux of blood from the aorta into the left ventricle during DIASTOLE
What is aortic regurgitation also known as/called?
What are the 2 groups of causes of aortic regurgitation?
Aortic valve leaflet abnormality/damage
Aortic root/ascending aorta dilation
Examples of aortic valve leaflet abnormality/damage causes of aortic regurgitation?
Bicuspid aortic valve (congenital)
Dilation of aortic root/ascending aorta causes of aortic regurgitation?
(other rarer stuff)
When does chronic AR begin and in what age group is it most frequently documented?
Chronic AR often begins in late 50s
Documented most frequently in >80s
Presentation of AR (chronic and severe acute)?
- initially asymptomatic
- symptoms of heart failure start to appear (exertional dyspnoea, orthopnoea, fatigue)
- sudden cardiovascular collapse
There may be symptoms associated with the cause e.g. tearing central chest pain from aortic dissection
3 standard signs of AR on examination?
- Collapsing 'water-hammer' pulse
- Wide pulse pressure
- Thrusting and heaving displaced apex beat (volume-loaded)
More specific exam-oriented signs of AR on examination? (auscultation + murmur site/position)
- Traube's sign 'pistol shot' auscultation of femoral arteries
- Early diastolic murmur at lower left sternal edge, best heard with patient sitting forward with breath held in expiration
Investigations for AR?
Cardiac catheterisation with angiography
CXR signs of AR?
Dilation of ascending aorta
Pulmonary oedema (due to left heart failure)
ECG signs of AR?
Signs of left ventricular hypertrophy
- deep S wave (V1-2)
- tall R wave (V5-6)
- inverted T waves (I, aVL, V5-6)
- left axis deviation
Potential echocardiogram signs of AR?
- Underlying cause (aortic root dilation or bicuspid aortic valve)
- Effects of AR (left ventricular dilation/dysfunction)
How is AR detected and severity assessed? (same investigation)
Why is follow-up echocardiogram necessary in AR?
Serial measurement of LV size and function