Aortic regurgitation: Difference between revisions
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*[[Endocarditis]] | *[[Endocarditis]] | ||
*[[Aortic dissection]] | *[[Aortic dissection]] | ||
**Always suspect in acute aortic | **Always suspect in acute aortic regurgitation | ||
*Blunt [[chest trauma]] | *Blunt [[chest trauma]] | ||
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*[[Pulmonary edema]] | *[[Pulmonary edema]] | ||
*Wide pulse pressure | *Wide pulse pressure | ||
*Dyspnea | *[[Dyspnea]] | ||
*[[Hypotension]] (may progress to cardiogenic shock) | *[[Hypotension]] (may progress to cardiogenic shock) | ||
*Decrescendo diastolic [[murmur]] heard immediately after S2 | *Decrescendo diastolic [[murmur]] heard immediately after S2 | ||
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*Reduce afterload | *Reduce afterload | ||
**[[Nitroprusside]] | **[[Nitroprusside]] | ||
*Diuretics and nitrates do not work | *Diuretics and nitrates do ''not'' work | ||
*Do not use β-blockers (block compensatory tachycardia) | *Do ''not'' use β-blockers (block compensatory tachycardia) | ||
==Disposition== | ==Disposition== | ||
Revision as of 23:40, 23 September 2019
Background
Causes
- Endocarditis
- Aortic dissection
- Always suspect in acute aortic regurgitation
- Blunt chest trauma
Clinical Features
- Pulmonary edema
- Wide pulse pressure
- Dyspnea
- Hypotension (may progress to cardiogenic shock)
- Decrescendo diastolic murmur heard immediately after S2
Differential Diagnosis
Valvular Emergencies
Evaluation
Consider the following tests
- CXR may be helpful
- May see pulmonary edema with out cardiac enlargement
- Left ventricular hypertrophy and dilated aorta
- Transthoracic echo will provide a more definitive diagnosis
Management
- Immediate surgical intervention
- Reduce afterload
- Diuretics and nitrates do not work
- Do not use β-blockers (block compensatory tachycardia)