Aortic regurgitation causes: Difference between revisions

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|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | After [[aortic valvuloplasty]]<ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref>, [[Aortic dissection]], [[Arteriosclerosis]], [[Bacterial Endocarditis]], [[Bicuspid aortic valve]], [[Prosthetic valve]] dysfunction<ref>Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.</ref>, [[Hypertension]], [[Myxomatous]] aortic valve, [[Rheumatic Fever]], [[Sinus of Valsalva Aneurysm]], [[Ventricular Septal Defect]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | After [[aortic valvuloplasty]]<ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref>, [[Aortic dissection]], [[Arteriosclerosis]], [[Bacterial Endocarditis]], [[Bicuspid aortic valve]], [[Prosthetic valve]] dysfunction<ref>Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.</ref>, [[Hypertension]], [[Myxomatous]] aortic valve, [[Rheumatic Fever]], Senile aortic ectasia and dilation, Senile or degenerative calcific aortic valve disease, [[Sinus of Valsalva Aneurysm]], [[Ventricular Septal Defect]]
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| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Psoriatic arthritis]]
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| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Whipple disease]]<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
|bgcolor="Beige"| [[Ulcerative colitis]], [[Whipple disease]]<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Ankylosing Spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>, [[Ehlers-Danlos Syndrome]], [[Marfan Syndrome]], [[Pseudoxanthoma Elasticum]], [[Reiter's Syndrome]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Systemic Lupus Erythematosus]], [[Takayasu arteritis]], [[Turner's Syndrome]]
|bgcolor="Beige"| [[Ankylosing Spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>, [[Ehlers-Danlos Syndrome]], [[Marfan Syndrome]], [[Osteogenesis imperfecta]], [[Pseudoxanthoma Elasticum]], [[Reiter's Syndrome]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Systemic Lupus Erythematosus]], [[Takayasu arteritis]], [[Turner's Syndrome]]
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| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Ankylosing Spondylitis]], [[Ehlers-Danlos Syndrome]], [[Reiter's Syndrome]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Systemic Lupus Erythematosus]]
|bgcolor="Beige"| [[Ankylosing Spondylitis]], [[Collagen vascular disease]], [[Ehlers-Danlos Syndrome]], [[Osteogenesis imperfecta]], [[Psoriatic arthritis]], [[Reiter's Syndrome]], [[Relapsing polychondritis]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Spondyloarthropathy]], [[Systemic Lupus Erythematosus]]
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| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing Spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>, [[Bechterew's Disease]], [[Behcet disease]], [[Cystic medial necrosis]], [[Ehlers-Danlos Syndrome]], [[Giant cell arteritis]], [[Marfan Syndrome]], [[Myxomatous]] aortic valve: The valvular structure can degenerate, [[Polymyalgia Rheumatica]], [[Pseudoxanthoma Elasticum]], [[Reiter's Syndrome]], [[Rheumatic Fever]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Systemic Lupus Erythematosus]], [[Takayasu arteritis]], [[Whipple disease]]<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
|bgcolor="Beige"| [[Ankylosing Spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>, [[Bechterew's Disease]], [[Behcet disease]], [[Collagen vascular disease]], [[Cystic medial necrosis]], [[Ehlers-Danlos Syndrome]], [[Giant cell arteritis]], [[Marfan Syndrome]], [[Myxomatous]] aortic valve: The valvular structure can degenerate, [[Osteogenesis imperfecta]], [[Polymyalgia Rheumatica]], [[Pseudoxanthoma Elasticum]], [[Psoriatic arthritis]], [[Reiter's Syndrome]], [[Rheumatic Fever]], [[Rheumatoid Arthritis]]<ref>Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.</ref>, [[Spondyloarthropathy]], [[Systemic Lupus Erythematosus]], [[Takayasu arteritis]], [[Ulcerative colitis]], [[Whipple disease]]<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
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Revision as of 17:57, 17 April 2012

Aortic Regurgitation Microchapters

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

Aortic insufficiency can be an acute illness or a chronic illness and the causes differ depending upon the acuity of the disease. In general, aortic insufficiency is due to abnormalities of the aortic valve itself or the aortic root. Aortic regurgitation secondary to dilation of the ascending aorta has overtaken valvular aortic disease as the most common cause of aortic regurgitation.

Common Causes

  • Worldwide the most common cause of aortic insufficiency is rheumatic heart disease.
  • In the United States, senile degenerative calcific aortic valve disease and bicuspid aortic valve disease are the most common causes.
  • Aortic regurgitation secondary to dilation of the ascending aorta has overtaken valvular aortic disease as the most common cause of aortic regurgitation.

Differential Diagnosis of the Causes of Aortic Insufficiency

By Organ System

Cardiovascular After aortic valvuloplasty[1], Aortic dissection, Arteriosclerosis, Bacterial Endocarditis, Bicuspid aortic valve, Prosthetic valve dysfunction[2], Hypertension, Myxomatous aortic valve, Rheumatic Fever, Senile aortic ectasia and dilation, Senile or degenerative calcific aortic valve disease, Sinus of Valsalva Aneurysm, Ventricular Septal Defect
Chemical / poisoning No underlying causes
Dermatologic Psoriatic arthritis
Drug Side Effect Fenfluramine and Dexfenfluramine: These drugs have been associated with degeneration of the aortic valve.
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Ulcerative colitis, Whipple disease[3]
Genetic Ankylosing Spondylitis[4], Ehlers-Danlos Syndrome, Marfan Syndrome, Osteogenesis imperfecta, Pseudoxanthoma Elasticum, Reiter's Syndrome, Rheumatoid Arthritis[5], Systemic Lupus Erythematosus, Takayasu arteritis, Turner's Syndrome
Hematologic No underlying causes
Iatrogenic After aortic valvuloplasty[1], Prosthetic valve dysfunction
Infectious Disease Bacterial Endocarditis, Rheumatic Fever, Syphilis
Musculoskeletal / Ortho Ankylosing Spondylitis, Collagen vascular disease, Ehlers-Danlos Syndrome, Osteogenesis imperfecta, Psoriatic arthritis, Reiter's Syndrome, Relapsing polychondritis, Rheumatoid Arthritis[6], Spondyloarthropathy, Systemic Lupus Erythematosus
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Ankylosing Spondylitis[7], Bechterew's Disease, Behcet disease, Collagen vascular disease, Cystic medial necrosis, Ehlers-Danlos Syndrome, Giant cell arteritis, Marfan Syndrome, Myxomatous aortic valve: The valvular structure can degenerate, Osteogenesis imperfecta, Polymyalgia Rheumatica, Pseudoxanthoma Elasticum, Psoriatic arthritis, Reiter's Syndrome, Rheumatic Fever, Rheumatoid Arthritis[8], Spondyloarthropathy, Systemic Lupus Erythematosus, Takayasu arteritis, Ulcerative colitis, Whipple disease[9]
Sexual Syphilis
Trauma Blunt chest trauma disrupting the supporting apparatus of the aortic valve.
Urologic No underlying causes
Miscellaneous Myxomatous aortic valve

Differential Diagnosis of the Causes of Acute Aortic Insufficiency

In alphabetical order:

Differential Diagnosis of the Causes of Chronic Aortic Insufficiency

In alphabetical order:

Differential Diagnosis Based Upon Aortic Valvular Causes

Differential Diagnosis Based Upon Abnormalities of the Ascending Aorta

References

  1. ↑ 1.0 1.1 1.2 Isner JM (1991). "Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators". Journal of the American College of Cardiology. 17 (6): 1436–44. PMID 2016464. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. ↑ Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.
  3. ↑ Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.
  4. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  5. ↑ Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.
  6. ↑ Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.
  7. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  8. ↑ Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.
  9. ↑ Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.
  10. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  11. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  12. ↑ Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.
  13. ↑ Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Cardiol Rev. Mar-Apr 2007;15(2):55-61.
  14. ↑ Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.
  15. ↑ Jain D, Halushka MK. Cardiac pathology of systemic lupus erythematosus. J Clin Pathol. Jul 2009;62(7):584-92.
  16. ↑ Moyssakis I, Tektonidou MG, Vasilliou VA, Samarkos M, Votteas V, Moutsopoulos HM. Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution. Am J Med. Jul 2007;120(7):636-42.
  17. ↑ Lee JL, Naguwa SM, Cheema GS, Gershwin ME. Revisiting Libman-Sacks endocarditis: a historical review and update. Clin Rev Allergy Immunol. Jun 2009;36(2-3):126-30.
  18. ↑ Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg. Dec 2007;84(6):1950-3.
  19. ↑ Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.

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