Aortic regurgitation


Causes (due to valve disease)
  • Rheumatic fever
  • Infective endocarditis
  • Connective tissue diseases e.g. RA/SLE
  • Bicuspid aortic valve

Causes (due to aortic root disease)
  • Aortic dissection
  • Spondylarthropathies (e.g. ankylosing spondylitis)
  • Hypertension
  • Syphilis
  • Marfan's, Ehler-Danlos syndrome

Clinical features

  • Early diastolic murmur: intensity of the murmur is increased by the handgrip manoeuvre
  • Collapsing pulse
  • Wide pulse pressure
  • Quinke's sign (nailbed pulsation)
  • De Musset's sign (head bobbing)
  • Mid-diastolic Austin-Flint murmur in severe AR - due to partial closure of the anterior mitral valve cusps caused by the regurgitation streams