Clinical manifestations and diagnosis of chronic aortic regurgitation in adults
- William H Gaasch, MD
William H Gaasch, MD
- Section Editor — Valvular Disease
- Professor of Medicine
- University of Massachusetts Medical School
- Tufts University School of Medicine
- Senior Consultant in Cardiology
- Lahey Clinic
Aortic regurgitation (AR, also called aortic insufficiency) is caused by inadequate closure of the aortic valve leaflets. It can be induced either by disease of the aortic valve leaflets or by distortion or dilation of the aortic root and ascending aorta.
This topic will review the causes, epidemiology, pathophysiology, and major clinical features of chronic AR. Issues related to course and therapy and to acute AR are discussed separately. (See "Natural history and management of chronic aortic regurgitation in adults" and "Acute aortic regurgitation in adults".)
At least trace aortic regurgitation (AR) by color Doppler echocardiography is common, even in healthy subjects. A study from the Framingham Heart Study found that, in a population-based cohort, AR of at least trace severity on color Doppler echocardiography was present in 13 percent of men and 8.5 percent of women .
The prevalence of AR varied with age and disease severity . More than trace AR was unusual before age 50 and then increased progressively.
●For mild AR, the prevalence was 3.7, 12.1, and 12.2 percent in men at ages 50 to 59, 60 to 69, and 70 to 83, respectively. The comparable values in women were 1.9, 6.0, and 14.6 percent.
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- CLINICAL MANIFESTATIONS
- Physical examination
- - Arterial pulse and related findings
- - Precordial examination
- - Cardiac auscultation
- Chest radiograph
- DIAGNOSIS AND EVALUATION
- When to suspect chronic aortic regurgitation
- Approach to diagnosis and evaluation
- - Findings
- Severity of AR
- Bicuspid aortic valve and aortic disease
- Cardiovascular magnetic resonance
- Invasive angiography
- DIFFERENTIAL DIAGNOSIS
- SERIAL MONITORING
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS