Aortic regurgitation: Difference between revisions
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Revision as of 13:53, 22 March 2016
Background
Causes
- Endocarditis
- Aortic dissection
- Always suspect in acute aortic regugitation
- 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
Diagnosis
consider the following tests
- CXR may be helpful
- May see pulmonary edema w/o cardiac enlargement
- Left ventricular hypertrophy and dilated aorta
- Transthoracic echo will provide a more definitive diagnosis
Treatment
- Immediate surgical intervention
- Reduce afterload
- Diuretics and nitrates don't work
- Don't use beta blockers (block compensatory tachycardia)