"CT "
"Although chronic aortic regurgitation can be asymptomatic, even in reasonably severe disease, it eventually leads to left-predominant clinical features of heart failure such as dyspnoea and angina 1-3. Clinical examination classically reveals a widened pulse pressure, pulsus bisferiens, a volume-loaded (‘thrusting’) apex beat, and a decrescendo early diastolic murmur (the Key-Hodgkin murmur) that is heard on praecordial auscultation 1-4."
"An additional parameter and predictor of severe aortic regurgitation in the absence of congenital heart disease is a holodiastolic flow reversal (HDR) in the descending aorta 12."
Expected headings
"Ultrasound: echocardiography"
"CT "
"Complications"
"root disease: hypertension, congenital bicuspid aortic valve, connective tissue disorders (e.g. Marfan syndrome, Ehlers-Danlos syndrome, osteogenesis imperfecta, etc.), aortic dissection, Takayasu arteritis, syphilitic aortitis, etc."
"valvular: rheumatic heart disease, calcific aortic valve disease (i.e. calcific aortic stenosis), bacterial infective endocarditis, prolapse, quadricuspid aortic valve, ankylosing spondylitis, syphilitic aortitis, radiation-induced heart disease, etc."
"iatrogenic (e.g. during transcatheter aortic valve implantation)"
"Echocardiography is useful for evaluating the cause of aortic regurgitation, either valvular or due to root disease, for assessing the regurgitant volume, and for assessing the left ventricle 3,7. Features which may be suggestive on 2D echocardiography include failure of valvular coaptation, flail or prolapsed leaflets, and when chronic, progressive left ventricular dilation. Various parameters are used to determine severity, such as 3,7:"
"Left ventricular structural derangements in chronic aortic regurgitation progress in proportion to the degree of regurgitant volume; a normal or hyperdynamic left ventricle in the presence of severe features suggests that the valvulopathy is acute 3,7."