Aortic regurgitation

Aortic regurgitation arises on the basis of:


 * aortic root dilatation (eg Marfan's syndrome, Ehlers-Danlos syndrome ),
 * ascending aortic dissection ,
 * infectious endocarditis ,
 * receded valve tips,
 * congenital defect of bicuspid valve,
 * after rheumatism,
 * trauma.

The clinical picture
Aortic regurgitation has long been asymptomatic. It is manifested by fatigue, exertional dyspnoea and angina.

Physical findings
Blowing diastolic (early to middle-diastolic) murmur above the aortic orifice, decrescendant, with a maximum at the Erb's point (3rd intercostal space left at the sternum), ie along the left edge of the sternum, intensifying while sitting, propagation to the apex of the heart. We can hear Austin Flint's diastolic mitral murmur resembling mitral stenosis, which is caused by premature closure of the anterior tip of the mitral valve by a stream of regurgitating blood from the aorta, it can be heard at the tip. Thus, the anterior mitral tip causes relative stenosis of the mitral orifice.

Great systolic-diastolic range of blood pressure, diastolic blood pressure sometimes can not be deducted (the phenomenon of endless tone ) occurs nimble Corrig pulse (magnus, celery et altus), Quincke capillary flag (compression nail pulsates edge lunula) and Mussetův flag (shaking head with pulsation ).

Diagnosis

 * X-ray of the heart and lungs - the aortic shape of the heart, highlighting the arch of the left ventricle and the aorta and the incision between them, always occur after endocarditis,
 * ECG - left ventricular hypertrophy, Doppler measurement of regurgitation jet, visualization of tips, EF, size of cardiac compartments
 * Transthoracic (TTE) and esophageal tube (TEE) echocardiography - a sovereign diagnostic method.

Therapy
Cardiac surgery for aortic valve replacement or aortic valve and root replacement ( Bental's operation ). Hypertensive patients - high blood pressure for increased heart rate volume, and therefore in the treatment we try to reduce blood pressure ACEi, Ca 2+ -blockers, temporarily diuretics.

Auscultation
https://www.youtube.com/watch?v=waFHKp8uX6k

Related articles

 * Vrozené srdeční vady • Získané srdeční vady
 * Aorta abdominalis • Aorta thoracica
 * Aortální stenóza • Výduť břišní aorty
 * Elastická artérie (histologický preparát)