Aortic regurgitation |
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Aortic
regurgitation results from abnormalities of the valve cusps or aortic
root preventing close apposition of the free margins of the valve leaflets.
Chronic regurgitation results in left ventricular volume overload and
progressive dilatation of the left ventricle. Symptoms are of heart failure
and angina. Valvular
causes of aortic regurgitation include congenitally malformed valve
leaflets, infectious endocarditis, and connective tissue disorders. Aortic root
causes of aortic regurgitation include cystic medial necrosis, Marfan's syndrome, aortic dissection, inflammatory diseases
and severe hypertension. Color
doppler echocardiography,
and recently MRI, are used to detect the regurgitant
jet across the aortic valve. The aortic valve may show calcifications,
thickening, congenital deformity, vegetations, rupture, or prolapse.
The normal valve area is 3-4 cm2 in adults. The aortic root may be dilated,
have calcifications or evidence of dissection. If the aortic root is
dilated, evaluation of valve morphology is important for determining
if valve replacement is necessary when surgery is performed. Treatment
for aortic regurgitation due to aortic dissection requires surgery.
Infective endocarditis requires antibiotics
and may require surgery. Systemic hypertension is treated as it exacerbates
regurgitation. Valve replacement surgery is performed in symptomatic
patients with left ventricular dysfunction. Source:
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