Aortic regurgitation symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The symptoms of acute aortic regurgitation (AR) include [[dyspnea]], [[chest pain]] ( | The symptoms of acute aortic regurgitation (AR) include [[dyspnea]], [[chest pain]] (if [[aortic dissection]] is the cause of AR), [[weakness]], and symptoms of [[congestive heart failure]]. Chronic AR may be asymptomatic for several years until there is a decrease in the [[stroke volume]] and [[cardiac output]] due to [[heart failure]] progression. Symptoms of chronic AR include [[exertional dyspnea]], [[orthopnea]], [[paroxysmal nocturnal dyspnea]], and [[palpitations]]. | ||
==History and Symptoms== | ==History and Symptoms== | ||
===Acute Aortic | ===Acute Aortic Regurgitation=== | ||
In acute severe | In acute severe AR, there is a sudden decrease in the [[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 [[aortic dissection]] is the cause of AR). Based on the history and symptoms, the cause of the acute symptoms can be suspected. | ||
====Type A Aortic Dissection==== | |||
* [[Chest pain]] of the following characteristics: | * [[Chest pain]] of the following characteristics: | ||
** Sudden onset | ** Sudden onset | ||
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** [[Connective tissue disorder]] | ** [[Connective tissue disorder]] | ||
====Infective Endocarditis==== | |||
* Persistent [[fever]] | * Persistent [[fever]] | ||
* New valvular regurgitation murmur | * New valvular regurgitation murmur | ||
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* History of previous endocarditis | * History of previous endocarditis | ||
Symptomatic | ====Symptomatic Severe Chronic AR==== | ||
* Previous history of aortic valve disease | * Previous history of aortic valve disease | ||
Revision as of 23:02, 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 (if aortic dissection is the cause of AR), weakness, and symptoms of congestive heart failure. Chronic AR may be asymptomatic for several years until there is a decrease in the stroke volume and cardiac output due to heart failure progression. Symptoms of chronic AR include exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations.
History and Symptoms
Acute Aortic Regurgitation
In acute severe AR, there is a sudden decrease in the 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 aortic dissection is the cause of AR). Based on the history and symptoms, the cause of the acute symptoms can be suspected.
Type A Aortic Dissection
- 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:
Infective Endocarditis
- 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