Sudden Severe Aortic Regurgitation

1. What are the most likely causes of sudden severe AR?

ANS: (a) Infective endocarditis, and

(b) rupture of an aneurysm of a sinus of Valsalva.

2. How are the heart sounds and diastolic murmurs affected by sudden severe AR?

ANS: The Sj is soft or absent and there may be a loud S3-like sound in mid-diastole due to closure of the mitral valve. The diastolic murmur tends to be relatively short and soft.

Note: a. In some cases of acute severe AR, the blood pressure may be average, i.e., in the range of 115/75 instead of the usual high systolic and low diastolic of chronic severe AR. b. The tachycardia of sudden, severe AR often causes diastole to equal, or even be shorter than, systole, so that it is difficult to tell systole from diastole by auscultation. This occurs because ejection is prolonged by the severe LV volume overload, and the diastolic period may be further shortened by tachycardia. Carotid or apical palpation during auscultation is mandatory to avoid confusing systole with diastole.

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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