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Aortic
regurgitation
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- The heart pumps blood from the left ventricle (left
lower chamber) of the heart to the rest of the body by
way of a large blood vessel known as the aorta. The aortic
valve, located between the left ventricle and the aorta,
opens when the ventricle pumps blood to the aorta, and
closes (passively) when at rest (i.e., between heartbeats).
If the valve leaflets are damaged or fail to close properly,
blood leaks back from the aorta into the left ventricle
between heartbeats. This is known as aortic
regurgitation.
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- Usually none until age 40-50
- Fatigue
- Shortness of breath on exertion
- Shortness of breath while resting
prone
- Chest pain
- Lightheadedness
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- Chronic (slow onset) aortic regurgitation, e.g.,
rheumatic heart disease --
- Decreased diastolic blood pressure
- Wide pulse pressure (large
difference between systolic and diastolic)
- Pulse has a rapid rise and fall
(known as a Corrigan's pulse)
- Diastolic murmur over a partially
compressed femoral artery
- Nail bed capillaries show
pulsations
- Apical heart impulse is prominent
- Heart reveals a high-pitched decrescendo (decreasing in
loudness) diastolic murmur in the aortic area. An
Austin Flint murmur may be present (low-pitched, mid or
late diastolic murmur).
- Electrocardiogram
shows left ventricular hypertrophy
- Chest X-Rays shows an
enlarged heart (cardiomegaly)
- Acute aortic regurgitation, e.g., infective endocarditis
--
- Sudden onset of aortic
regurgitation murmur
- Lungs may reveal crackles of Pulmonary Edema
- Echocardiogram --
reveals the valve abnormality, and Doppler studies show the
degree of regurgitation.
- Scintigraphic studies can asses left
ventricular function
- Cardiac catheterization is often helpful
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- Vasodilator medications such as
ACE inhibitors, hydralazine, and nifedipine can decrease
the severity of the regurgitation.
- Beta-blocker medications may slow progression in those with Marfan's Syndrome.
- Surgical valve replacement in those with symptoms or
significant left ventricular dysfunction
- Usually caused by infective endocarditis -- surgical
replacement of the valve is usually needed. Vasodilators may
temporarily stabilize the
condition.
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- Acute aortic regurgitation -- this
is a life-threatening medical condition. Seek immediate
emergency medical treatment.
- Chronic aortic regurgitation -- this condition needs to
be followed carefully by your physician. A cardiologist is
often consulted.
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- Persons with aortic regurgitation should have antibiotic prophylaxis to prevent infective endocarditis. This includes dental, respiratory, esophageal, gastrointestinal, and genitourinary procedures.
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