LA enlargement, LV enlargement, high-frequency diastolic fluttering of mitral valve. Failure of coaptation of aortic valve leaflets may be present. Doppler studies useful in detection and quantification of AR. Cardiac magnetic resonance imaging helpful if echo is inadequate.
Treatment: Aortic Regurgitation Standard therapy for LV failure (Chap. 124. Heart Failure and Cor Pulmonale). Vasodilators (ACE inhibitor or long-acting nifedipine) are recommended if hypertension present. Avoid beta blockers, which prolong diastolic filling. Surgical valve replacement should be carried out in pts with severe AR when symptoms develop or in asymptomatic pts with LV dysfunction (e.g., LVEF <50%, end-systolic diameter >50 mm, or LV diastolic dimension >65 mm) by imaging studies. |