Aortic Regurgitation Medical Slides

Create a comparison slide: acute AR presents with flash pulmonary edema, tachycardia, narrow pulse pressure (LV cannot dilate acutely), and soft/absent diastolic murmur — it is a surgical emergency. Chronic AR shows wide pulse pressure, hyperdynamic pulses (Corrigan, de Musset, Quincke signs), displaced PMI, and a loud blowing diastolic murmur. Echo hallmark of acute AR: premature mitral valve closure.

Per the 2020 ACC/AHA guidelines: severe AR with normal LV function — echo every 6-12 months with clinical assessment every 6 months. Moderate AR — echo every 1-2 years. Mild AR — echo every 3-5 years. Emphasize that exercise testing can unmask symptoms in apparently asymptomatic patients and is a Class IIa recommendation for equivocal cases.

Present Class I indications: symptomatic severe AR, asymptomatic with LVEF ≤55%, or asymptomatic undergoing other cardiac surgery. Include the 2020 ACC/AHA Class IIa triggers: LVESD >50 mm or indexed >25 mm/m², LVEDV index >65 mL/m², and progressive LV dilation on serial imaging. Discuss valve-sparing root replacement (David procedure) for root dilation with normal leaflets to avoid lifelong anticoagulation.