What is Aortic regurgitation (AR)?

is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole

The causes of Aortic regurgitation can be grouped into two main causes?

• Causes of AR due to valve disease
• Causes of AR due to aortic root disease

What are the chronic presentation causes of aortic regurgitation due to valve disease?

• rheumatic fever: the most common cause in the developing world
• calcific valve disease
• connective tissue diseases e.g. rheumatoid arthritis/SLE
• bicuspid aortic valve (affects both the valves and the aortic root)

What are the chronic presentation causes of aortic regurgitation due to aortic root disease?

• bicuspid aortic valve (affects both the valves and the aortic root)
• spondylarthropathies (e.g. ankylosing spondylitis)
• hypertension
• syphilis
• Marfan's, Ehler-Danlos syndrome

What are the acute presentation causes of aortic regurgitation due to aortic root disease?

aortic dissection

What are the acute presentation causes of aortic regurgitation due to valve disease?

infective endocarditis

What type of murmur is heard in Aortic regurgitation?

early diastolic murmur

What are the characteristics of the pulse you may see in Aortic regurgitation?

• collapsing pulse
• wide pulse pressure

What type of murmur may you hear in severe Aortic regurgitation?

mid-diastolic Austin-Flint murmur

What are the indication of valve replacement for Aortic regurgitation?

• symptomatic patients with severe AR
• asymptomatic patients with severe AR who have LV systolic dysfunction