Cardiovascular · UKMLA & AKT
Aortic regurgitation
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Early diastolic murmur - high-pitched, blowing; best heard at left lower sternal border (3rd-4th ICS), patient sitting forward, leaning forward, breathing out
- Murmur loudest at right sternal border suggests aortic root dilatation (e.g. Marfan's, ascending aortic aneurysm)
- Austin-Flint murmur - mid-to-late diastolic rumble at apex in severe AR; mimics mitral stenosis but no pathological mitral valve
- Collapsing (water hammer) pulse - forceful beat with rapid collapse; wide pulse pressure (elevated systolic, reduced diastolic)
- Displaced apex beat - laterally and inferiorly, due to LV dilatation
- Chronic AR symptoms - exertional dyspnoea (earliest), orthopnoea, PND, angina (even without CAD - reduced diastolic coronary perfusion), palpitations, fatigue
- Acute AR symptoms - cardiogenic shock, acute pulmonary oedema, tachypnoea; eponymous signs often attenuated
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