Aortic Regurgitation
Because examination findings in acute regurgitation differ from and are often more subtle than those in chronic regurgitation, the diagnosis is often missed when a patient presents with dyspnea and shock - Nahush A Mokadam
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Aortic regurgitation
Aortic regurgitation tends to present between the fourth and sixth decades of life. It affects males three times more commonly than women. Severe disease is seen in < 1% of the population. The most common causes are degenerative disease and congenital bicuspid valve... Patients may present acutely with features of heart failure in acute AR or have a prolonged period of little to no symptoms followed by gradual onset of symptoms in chronic disease... Acute AR is a surgical emergency. Aortic valve replacement or repair should be performed as soon as possible. It primarily occurs secondary to infective endocarditis or aortic dissection, both of which carry very high morbidity and mortality.
Resources
Acute Aortic Regurgitation (AR)
Unlike in chronic AR where there is time for compensatory LV dilation to maintain stroke volume and cardiac output while maintaining a more normal LVEDP, in acute AR the sudden increase in LV volume from the regurgitant flow into the noncompliant LV leads to sudden increase in LVEDP, left atrial pressure/PCWP, and subsequent pulmonary edema leading to the classic presentation of dyspnea, volume overload, and CS
Diagnosis and Management of Aortic Regurgitation
Aortic regurgitation (AR) is a condition where the aortic valve does not close properly, either due to primary disease of aortic valve leaflets and/or dilatation of aortic root and ascending aorta.
Diagnosis and Management of Severe Aortic Regurgitation
Severe acute AR commonly presents with signs of hemodynamic instability (dyspnea, syncope, or altered mental status) or frank cardiogenic shock. Other presenting symptoms are related to the cause of acute AR (e.g., signs and symptoms of aortic dissection or endocarditis)
Management of Acute Regurgitation in Left-Sided Cardiac Valves
The management of acute, severe cardiac valvular regurgitation requires expeditious multidisciplinary care. Although acute, severe valvular regurgitation can be a true surgical emergency, accurate diagnosis and subsequent treatment decisions require clinical acumen, appropriate imaging, and sound judgment.
Problem: Aortic Valve Regurgitation
What causes aortic regurgitation? Common causes of severe aortic regurgitation are bicuspid valve disease, congenital abnormalities, primary diseases in the ascending aorta or dilated aortic sinuses. Acute aortic regurgitation can be caused from bacterial infections of the heart tissue, after chest trauma or from calcific valve disease. How is aortic regurgitation treated? Severe aortic regurgitation may be treatable with medications to reduce blood clotting and reduce the risk of stroke, but surgical repairs or replacement are often needed.
Aortic regurgitation
Aortic regurgitation results from an incompetent aortic valve causing a regurgitant flow of blood in diastole.
StatPearls
Aortic regurgitation (AR), also known as aortic insufficiency, is a form of valvular heart disease in which the integrity of the aortic valve is compromised and leads to inadequate closure of the valve leaflets. A normal aortic valve is comprised of three semilunar cusps that attach to the aortic wall.
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