Aortic Regurgitation

Brief Information

Valve incompetence allows backflow from aorta to ventricle. Caused by rheumatic heart disease, endocarditis, aortic diseases (Marfan’s syndrome, medial necrosis), syphilis, ankylosing spondylitis, dissection, cardiac trauma.

Type and Detection
Heard with diaphragm, patient sitting and leaning forward; Austin-Flint murmur heard with bell; ejection click heard in 2nd intercostal space
Findings on Examination
Early diastolic, high pitch, blowing, often with diamond-shaped midsystolic murmur, sounds often not prominent; duration varies with blood pressure; low-pitched rumbling murmur at apex common (Austin-Flint); early ejection click sometimes present.

In left ventricular hypertrophy, prominent prolonged apical impulse down and to left Pulse pressure wide; water-hammeror biferiens pulse common in carotid, brachial, and femoral arteries.

Heart Sound Components
S1 soft; S2 split may have tambour- like quality; M1 and A2 often intensified; S3-S4 gallop is common.

Heart Sound
Compare with
Normal Heart Sound (441K)
Aortic Stenosis (392K)
Mitral Stenosis (424K)
Pulmonary Stenosis (438K)
Mitral Regurgitation (438K)

Y.E. Kocabasoglu and R.H. Henning

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