Aortic Regurgitation

1. Natural History

a) Etiology

i) Endocarditis

ii) Mediodegeration - Ascend Aortic dilatation

a) Acquired

b) Marfans

iii) Dissection

iv) Rheumatic & Syphilis

a) Less common now

2. Symptoms

a) Presence of symptoms is ominous - have < 5 years life expectancy

b) CCF

c) Dyspnea

d) Palpitation

e) Angina

3. Pressure-volume loops

a) In chronic AR eccentric compensation occurs leading to massive increases in LVEDV and LVESV

b) An increase in LV compliance over time allows the LVEDP to be only mildly elevated

c) These compensatory mechanisms allow the SV can be maintained

4. Gross Anatomy

§ Dilated & hypertrophied left ventricle

5. Pathophysiology