26 Questions
What is the primary cause of acute aortic regurgitation?
Bacterial endocarditis
Which factor determines the severity of aortic regurgitation?
Diastolic pressure gradient between aorta and left ventricle
What is the effect of aortic regurgitation on systolic blood pressure?
Increase
Which condition may lead to chronic aortic regurgitation?
Congenital bicuspid valve
What does diastolic reflux through the aortic valve lead to?
Left ventricular volume overload
What is the pathophysiological mechanism underlying acute aortic regurgitation?
Bacterial endocarditis
Which treatment modality may reduce afterload and diminish regurgitant volume in chronic aortic regurgitation?
Vasodilator therapy
In which patients should antibiotic prophylaxis be considered prior to certain dental procedures?
At-risk patients, e.g., with prosthetic valves or a history of infective endocarditis
What is the recommended surgical treatment for symptomatic patients with chronic aortic regurgitation?
Aortic valve replacement
In asymptomatic patients with normal LVEF, when should aortic valve replacement surgery or valve repair be undertaken?
If the LV end-diastolic dimension increases to greater than 7 cm
What is the recommended follow-up interval for asymptomatic patients with chronic aortic regurgitation and normal LVEF?
6-month intervals
What is the prognosis of asymptomatic patients with normal LVEF in terms of progression to symptoms or LV dysfunction per year?
< 6% per year
What is the prognosis of asymptomatic patients with decreased EF in terms of progression to symptoms per year?
> 25% per year
What is the mortality rate per year for symptomatic patients with chronic aortic regurgitation?
< 10% per year
What is the LV end-diastolic diameter threshold for deferring aortic valve replacement in asymptomatic patients with chronic aortic regurgitation?
> 7 cm
What is the threshold for considering surgical treatment in asymptomatic patients with chronic aortic regurgitation if the ejection fraction decreases?
< 50%
What is the most common cause of chronic aortic regurgitation in lower-income countries?
Rheumatic heart disease
What peripheral sign is characteristic of chronic aortic regurgitation?
Corrigan pulse
What is the preferred diagnostic tool if aortic dissection is suspected in acute aortic regurgitation?
Angio-CT of the aorta
What is the main objective of cardiac MRI in the evaluation of moderate to severe aortic regurgitation?
Evaluating anatomy and hemodynamics
What is the recommended initial treatment for acute aortic regurgitation in the emergency department?
Administering a positive inotrope and vasodilator
Which sign is associated with moderate to severe chronic aortic regurgitation?
Hill sign
What finding is characteristic of chest radiography in chronic aortic regurgitation?
Prominent aortic root/arch
What is the most significant ECG finding in chronic aortic regurgitation?
$RV6+SV2 > 35 mm$
What is the characteristic auscultatory finding in chronic aortic regurgitation due to valvular disease?
$High$-pitched, blowing, decrescendo early diastolic murmur
What is the primary diagnostic tool to diagnose aortic regurgitation and assess the severity of disease?
$Transthoracic$ echocardiography
Test your knowledge of aortic regurgitation classification, including acute AR primarily caused by bacterial endocarditis or aortic dissection, chronic AR due to congenital bicuspid valve or rheumatic fever, and the clinical implications of acute AR.
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