Clinical Findings in Chronic Aortic Regurgitation(AR)
Clinical Findings in Chronic Aortic Regurgitation (AR) for medical students, cardiologists, physicians and internists 2023
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| Clinical Findings in Chronic Aortic Regurgitation |
Introduction
Aortic regurgitation, a valvular heart disease, is a condition characterized by the backflow of blood from the aorta into the left ventricle of the heart during diastole, the relaxation phase of the cardiac cycle.
Causes of aortic regurgitation
This condition can be attributed to several causes, such as congenital valve abnormalities, rheumatic fever, or aortic root dilatation.
The severity of aortic regurgitation varies and is often categorized as mild, moderate, or severe, depending on the extent of blood leakage.
Diagnosis of aortic regurgitation
To diagnose aortic regurgitation, clinicians typically employ a combination of techniques, including echocardiography, Doppler ultrasound, and magnetic resonance imaging (MRI), to assess the valve function and determine the appropriate treatment approach.
Management of aortic regurgitation
Managing aortic regurgitation may involve medical management, such as medication to reduce symptoms and slow the progression of the disease, or surgical intervention, such as valve repair or replacement, depending on the severity of the condition and the patient’s overall health.
Importance of timely diagnosis
Timely diagnosis and intervention are crucial in preventing the progression of aortic regurgitation, as it can lead to serious complications if left untreated, including heart failure and irreversible damage to the heart muscle..
Signs of aortic regurgitation
Here we have listed multiple symptom and signs of chronic aortic regurgitation a clinician hould be looking for when suspected.
- Light House Sign – Blanching & Flushing of forehead
- Landolfi’s sign, alternating constriction & dilatation of pupils
- Becker’s Sign – visible pulsation of retinal arterioles
- De Musset Sign – Bobbing of head
- Muller’s Sign – To & fro movement of Uvula
- Gerhardt /Sailer Sign– Pulsation of Spleen in Splenomegaly
- Rosenbach’s Sign– Hepatic Pulsation
- Shelley’s Sign– Pulsation of Cervix
- Corrigan’s Sign– Forceful dilatation and quick collapse of Arterial pulse
- Water-hammer Pulse
- Quincke’s Sign-Nail bed Capillary Pulsation
- Wide Pulse Pressure
- Hill’s Sign– exaggerated difference in systolic arterial pressure between upper & lower limbs
- Traube’s Sign– Pistol Shot sounds over femoral artery
- Duroziez’s Sign– Pressure over femoral artery to & fro murmur
- Hill’s Sign– Popliteal artery systolic pressure exceeds Brachial artery pressure by > 60 mmHg
- Maybe’s Sign– Decrease in DBP of 15 mmHg when arm is held above head.
- Early diastolic, decrescendo murmur usually heard best Erb’s point
- The Austin Flint murmur is a rumbling diastolic murmur best heard at the apex.
- S3 gallop
- Systolic outflow tract murmur
- Wide pulse pressure
- High volume bounding pulse
- PMI shifts inferiorly & laterally
- It is important to palpate supra-eternal notch to rule out AAA
- Lincoln Sign– Tremor of foot when one leg is crossed above other
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