Aortic Regurgitation, Adult (Aortic Insufficiency)

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Aortic regurgitation, incompetence or insufficiency “AR/AI” is abnormal back flow of blood from the aorta to the left ventricle during diastole due to pathology affecting the valve o...

DIAGNOSIS

AR is usually detected by clinical examination or incidentally by echocardiography (2). 

HISTORY

  • Acute AR: acute symptoms: shortness of breath, chest pain, or collapse

  • Chronic AR: asymptomatic ...

TREATMENT

GENERAL MEASURES

Medications will not treat the regurgitation per se but aim to treat the underlying cause or to improve physiology, myocardial contractility, and cardiac output, thereby impr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Regular clinical follow-up with periodic echocardiography

  • Blood pressure control

  • Infective endocarditis prophylaxis is recommended for patients wi...

REFERENCES

Singh JP, Evans JC, Levy D, et al. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol.  1999;83(6):897–902....

ADDITIONAL READING

Onorati F, De Santo LS, Carozza A, et al. Marfan syndrome as a predisposing factor for traumatic aortic insufficiency. Ann Thorac Surg.  2004;77(6):2192–2194. 

CODES

ICD10

I35.1 Nonrheumatic aortic (valve) insufficiency 

ICD9

424.1 Aortic valve disorders 

SNOMED

  • 60234000 Aortic valve regurgitation

  • 194983005 Aortic incompetence, non-rheumatic

CLINICAL PEARLS

  • Acute AR is a surgical emergency. Timing of surgery is crucial for best outcome.

  • Chronic AR may remain asymptomatic for years but needs regular follow-up.

  • Echocardiography is the gold st...

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