Aortic regurgitation

Aortic regurgitation results from the diastolic, retrograde flow of blood through the aortic valve secondary to aortic root abnormalities, congenital defects, or other valvular pathology. This abnormal flow creates a diastolic decrescendo murmur best auscultated at the right or left upper sternal border and accentuated by after-load maneuvers. Clinically, patients are frequently found to have a widened pulse pressure due to the increased left ventricular ejection volume. The quality, timing, and intensity of the murmur can help to distinguish between acute and chronic aortic regurgitation. Although many patients are asymptomatic early in the disease process, over time this valvular dysfunction can lead to left ventricular hypertrophy and pulmonary venous congestion resulting in angina, dyspnea, and fatigue. Echocardiography is recommended for the diagnosis and evaluation of aortic regurgitation. Surgical intervention is only recommended for symptomatic patients with severe ventricular dysfunction or dilation.