Aortic regurgitation

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

• Mitral stenosis
• Mitral regurgitation
  • Mitral valve prolapse
• Aortic stenosis
• Aortic regurgitation

Diagnosis

• CXR
  • Pulmonary edema w/o cardiac enlargement

Treatment

• Immediate surgical intervention
• Reduce afterload
  • Nitroprusside
• Diuretics and nitrates don't work
• Don't use beta blockers (block compensatory tachycardia)

See Also

• Valvular emergencies
• Heart murmurs