Aortic regurgitation symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The symptoms of acute aortic regurgitation (AR) include [[dyspnea]], [[chest pain]] (when [[aortic dissection]] is the cause of AR), [[weakness]], and symptoms of [[congestive heart failure]]. Chronic AR may be without symptoms for several years until there is a decrease in the [[stroke volume]] and [[cardiac output]] due to [[heart failure]] progression. Symptoms of chronic aortic insufficiency include [[exertional dyspnea]], [[orthopnea]], [[paroxysmal nocturnal dyspnea]], and [[palpitations]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
Revision as of 22:57, 6 January 2015
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Aortic Regurgitation Microchapters |
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Diagnosis |
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Treatment |
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Acute Aortic regurgitation |
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Chronic Aortic regurgitation |
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Special Scenarios |
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Case Studies |
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Aortic regurgitation symptoms On the Web |
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American Roentgen Ray Society Images of Aortic regurgitation symptoms |
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Risk calculators and risk factors for Aortic regurgitation symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
The symptoms of acute aortic regurgitation (AR) include dyspnea, chest pain (when aortic dissection is the cause of AR), weakness, and symptoms of congestive heart failure. Chronic AR may be without symptoms for several years until there is a decrease in the stroke volume and cardiac output due to heart failure progression. Symptoms of chronic aortic insufficiency include exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations.
History and Symptoms
Acute Aortic Insufficiency
In acute severe aortic regurgitation (AR), there is a sudden decrease in stroke volume and increase in left ventricular end diastolic volume and left ventricular end diastolic pressure which manifests as either sudden and severe dyspnea and/or chest pain, if there is an aortic dissection. Based on the history and symptoms, the cause of the acute symptoms can be suspected.
- Chest pain of the following characteristics:
- Sudden onset
- Intense
- Tearing and sharp
- Worsened by deep breathing or cough
- Relieved by sitting upright
- Unexplained syncope
- Previous history of:
- Persistent fever
- New valvular regurgitation murmur
- Positive previous blood culture
- High risk factors:
- Pre-existing cardiac abnormality
- Prosthetic valve
- Recent surgical or medical procedures
- Intravenous drug use
- Recent bacterial infection
- History of previous endocarditis
Symptomatic severe chronic AR:
- Previous history of aortic valve disease
Chronic Aortic Insufficiency
In chronic aortic regurgitation (AR), patients are usually asymptomatic for many years as the stroke volume is maintained by increased force of left ventricular contraction secondary to increased left ventricular preload as explained by Frank-Starling mechanism.
With progression of AR, the compensatory mechanisms begin to fail causing gradual enlargement of the left ventricle, thereby progressively increasing left ventricular end diastolic pressure, decreasing stroke volume and cardiac output leading to left ventricular failure manifesting as:
- Dyspnea on exertion
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Palpitations (due to compensatory tachycardia)
- Chest pain (if left ventricular end diastolic pressure compromises coronary perfusion)
Once symptoms arise, cardiac function usually worsens more rapidly and mortality may exceed 10% per year.
Pertinent Elements in the Past Medical History
- Cardiac disease:
- Rheumatic fever
- Pulmonary disease
- Trauma
- Syphilis
- Ankylosing spondylitis
- Acromegaly
- Marfan syndrome
- Ehlers-Danlos syndrome
- Giant cell arteritis
- Takayasu's arteritis
- Previous cardiac surgery