Aortic Regurgitation Flashcards Preview

Year 3 Rapid Medicine Cardiology > Aortic Regurgitation > Flashcards

Flashcards in Aortic Regurgitation Deck (16)
Loading flashcards...
1

What is aortic regurgitation?

Reflux of blood from the aorta into the left ventricle during DIASTOLE

2

What is aortic regurgitation also known as/called?

Aortic insufficiency

3

What are the 2 groups of causes of aortic regurgitation?

Aortic valve leaflet abnormality/damage

Aortic root/ascending aorta dilation

4

Examples of aortic valve leaflet abnormality/damage causes of aortic regurgitation?

Bicuspid aortic valve (congenital)
Infective endocarditis
Rheumatic fever
Trauma

5

Dilation of aortic root/ascending aorta causes of aortic regurgitation?

Systemic hypertension
Aortic dissection
Aortitis
Arthritides
Marfan's
(other rarer stuff)

6

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

7

Presentation of AR (chronic and severe acute)?

Chronic AR
- initially asymptomatic
- symptoms of heart failure start to appear (exertional dyspnoea, orthopnoea, fatigue)

Severe acute
- sudden cardiovascular collapse

There may be symptoms associated with the cause e.g. tearing central chest pain from aortic dissection

8

3 standard signs of AR on examination?

- Collapsing 'water-hammer' pulse
- Wide pulse pressure
- Thrusting and heaving displaced apex beat (volume-loaded)

9

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

10

Investigations for AR?

CXR
ECG
Echo
Cardiac catheterisation with angiography

11

CXR signs of AR?

Cardiomegaly
Dilation of ascending aorta
Pulmonary oedema (due to left heart failure)

12

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

13

Potential echocardiogram signs of AR?

- Underlying cause (aortic root dilation or bicuspid aortic valve)

- Effects of AR (left ventricular dilation/dysfunction)

14

How is AR detected and severity assessed? (same investigation)

Doppler echocardiography

15

Why is follow-up echocardiogram necessary in AR?

Serial measurement of LV size and function

16

Why is cardiac catheterisation with angiography sometimes indicated in AR?

If there is uncertainty about the functional state of the ventricle or the presence of coronary artery disease