Clinical Findings in Chronic Aortic Regurgitation (AR) for medical students, cardiologists, physicians and internists 2023

Clinical Findings in Chronic Aortic Regurgitation(AR)

Clinical Findings in Chronic Aortic Regurgitation  (AR) for medical students, cardiologists, physicians and internists 2023

Clinical Findings in Chronic Aortic Regurgitation(AR)

Table of Contents (toc)

Introduction

Aortic regurgitation, a valvular heart disease, is a condition characterized by the backflow of blood from the aorta into the left ventricle of the heart during diastole, the relaxation phase of the cardiac cycle.

This condition can be attributed to several causes, such as congenital valve abnormalities, rheumatic fever, or aortic root dilatation. 

The severity of aortic regurgitation varies and is often categorized as mild, moderate, or severe, depending on the extent of blood leakage. 

To diagnose aortic regurgitation, clinicians typically employ a combination of techniques, including echocardiography, Doppler ultrasound, and magnetic resonance imaging (MRI), to assess the valve function and determine the appropriate treatment approach. 

Managing aortic regurgitation may involve medical management, such as medication to reduce symptoms and slow the progression of the disease, or surgical intervention, such as valve repair or replacement, depending on the severity of the condition and the patient's overall health. 

Timely diagnosis and intervention are crucial in preventing the progression of aortic regurgitation, as it can lead to serious complications if left untreated, including heart failure and irreversible damage to the heart muscle.

Here we have listed multiple symptom and signs of chronic aortic regurgitation a clinician hould be looking for when suspected.

1. Light House Sign - Blanching & Flushing of forehead 
   
   
2. Landolfi's sign, alternating constriction & dilatation of pupils
   
   
3. Becker’s Sign - visible pulsation of retinal arterioles 
   
   
4. De Musset Sign - Bobbing of head 
   
   
5. Muller’s Sign - To & fro movement of Uvula
   
   
6. Gerhardt /Sailer Sign- Pulsation of Spleen in Splenomegaly 
   
   
7. Rosenbach’s Sign- Hepatic Pulsation
   
   
8. Shelley’s Sign- Pulsation of Cervix
   
   
9. Corrigan’s Sign- Forceful dilatation and quick collapse of Arterial pulse
   
   
10. Water-hammer Pulse
    
    
11. Quincke’s Sign-Nail bed Capillary Pulsation
    
    
12. Wide Pulse Pressure
    
    
13. Hill's Sign- exaggerated difference in systolic arterial pressure between upper & lower limbs
    
    
14. Traube’s Sign- Pistol Shot sounds over femoral artery
    
    
15. Duroziez’s Sign- Pressure over femoral artery to & fro murmur
    
    
16. Hill’s Sign- Popliteal artery systolic pressure exceeds Brachial artery pressure by > 60 mmHg
    
    
17. Maybe’s Sign- Decrease in DBP of 15 mmHg when arm is held above head.
    
    
18. Early diastolic, decrescendo murmur usually heard best Erb's point
    
    
19. The Austin Flint murmur is a rumbling diastolic murmur best heard at the apex. 
    
    
20. S3 gallop
    
    
21. Systolic outflow tract murmur
    
    
22. Wide pulse pressure 
    
    
23. High volume bounding pulse 
    
    
24. PMI shifts inferiorly & laterally
    
    
25. It is important to palpate supra-eternal notch to rule out AAA
    
    
26. Lincoln Sign- Tremor of foot when one leg is crossed above other

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