cardiovascular disorders
Aortic Regurgitation
Diagnosis of Aortic Regurgitation
Echocardiography Diagnosis of aortic regurgitation is suspected based on history and physical examination findings and confirmed by Echocardiography . Doppler echocardiography is the test of choice to detect and quantify the magnitude of regurgitant blood flow and grade overall severity of the AR. Two-dimensional echocardiography can quantify aortic root size and anatomy and LV function. Severe chronic aortic regurgitationis suggested by any of the following: Color Doppler jet width≥65% of the LV outflow tract diameter Holodiastolic flow reversal in the abdominal aorta (specific for severe AR) Regurgitant volume≥60 mL/beat Regurgitation fraction≥50% Vena contracta>6 mm (the narrowest diameter of the fluid stream downstream of the abnormal valve orifice) Echocardiography None ECG and chest x-ray should be done. Electrocardiography None Chest x-raymay show cardiomegaly and a prominent aortic root in patients with chronic progressive AR. If AR is severe, signs of pulmonary edema and HF may also be present. Exercise testing may help assess functional capacity and symptoms in patients with documented AR and equivocal symptoms. Coronary angiographyshould be done before surgery, even if no angina is present because about 20% of patients with severe AR have significant coronary artery disease, which may need concomitant coronary artery bypass graft surgery. First-degree relatives of patients with a bicuspid valve should be screened using echocardiography because 20 to 30% will be similarly affected. 