Cardiovascular · UKMLA & AKT
Aortic regurgitation
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise aortic regurgitation — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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