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Aortic Regurgitation Essay

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AORTIC REGURGITATION
Aortic regurgitation(AR) refers to the failure of incompetent aortic valve to prevent the flow of blood from aorta back to the left ventricle.
HEMODYNAMICS:
The backward leak of blood from the aorta to left ventricle during diastole increases left ventricular volume. The left ventricle accommodates extra volume of blood by increasing ventricular size. This regurgitation leads to impaired forward systemic blood flow reducing cardiac output. Left ventricle increases ejection during early part of systole to compensate this. In increased regurgitation, left ventricular pressure increases, which may leads to increased left atrial pressure and pulmonary congestion.
CLINICAL FEATURES:
 Asymptomatic in mild form.
 Palpitation, dyspnea on
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 High pitched decrescendo diastolic murmur.
DIAGNOSIS:
 ECG: Normal or left ventricular hypertrophy, diastolic overloading pattern of left ventricle.
 Chest X-ray: Enlargement of left ventricle.
 Echocardiography: Dilated aorta, enlargement of left ventricle.
 Droppler study determine the severity of AR.
TREATMENT:
 Calcium channel blockers.
 Prevention of infective endocarditis.
 Surgery: Aortic valve replacement by homograft or prosthetic valve.
AORTIC STENOSIS:
Aortic stenosis results due to narrowing of aortic valve or adjacent part of aorta. This leads to a development of pressure gradient between left ventricle and aorta increasing the left ventricular pressure and hypertrophy. It is very rare in children.
CLINICAL FEATURES:
• Classical triad of exertional dyspnea, exertional angina and exertional syncope.
• Fatigue, exercise intolerance.
• Pulsus parvus et tardus (slow rising pulse).
• Narrow pulse pressure.
• Ejection systolic murmur.

DIAGNOSIS:
• ECG: Left ventricular hypertrophy.
• Chest X-ray: Cardiomegaly in case of CCF.
• Echocardiography: Identify site of
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