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Aortic regurgitation
From WikEM
Contents
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
- Aortic stenosis
- Aortic regurgitation
Evaluation
Consider the following tests
- CXR may be helpful
- May see pulmonary edema with out cardiac enlargement
- Left ventricular hypertrophy and dilated aorta
- Transthoracic echo will provide a more definitive diagnosis
Management
- Immediate surgical intervention
- Reduce afterload
- Diuretics and nitrates do not work
- Do not use beta blockers (block compensatory tachycardia)
