Q. Define Aortic regurgitation?
Aortic regurgitation is a common valvular disease that may present chronically or acutely. Normally the integrity of valve closure depends upon the anatomy of valve leaflets and on three dimensional geometry of aortic root and sinuses of Valsalva. Wide variety of causes may lead to aortic regurgitation. Usually 50 per cent of valve replacements are due to diseases of valve and 50 per cent due to root disease. However, in India predominant cause of aortic valve replacement is still rheumatic.
Table : Causes of Aortic Regurgitation
Acute - Aortic dissection
- Trauma
- Leaflet perforation due to endocarditis
Chronic
Valve leaflet disease - Congenital
Bicuspid
Unicuspid
Quadricuspid
Fenestrations
- Rheumatic
- Infective endocarditis
- Myxomatous degeneration
- Fibro calcific degeneration
- Systemic Lupus Erythematosus
- Rheumatoid
- Pharmacological agents
Aortic Root Disease - Hypertension
- Idiopathic root dilatation
- Marfan's Syndrome
- Aortic dissection
- Annuloaortic ecstasia
- Cystic medial necrosis
- Syphilis
- Ankylosing spondylosis
- Takayasu arteritis
- Psoriatic arthritis
- Reiter's Syndrome
- Relapsing Polychondritis
- Kawasaki disease
- Osteogeneses imperfecta
- Giant cell Arteritis
- Ehlers - Danlos Syndrome
Sub Valvular - Discrete sub aortic stenosis
- VSD with aortic regurgitation due to prolapse
Majority of elderly hypertensive patients have trivial to mild aortic regurgitation due to varying degrees of root dilatation due to hypertension and degenerative changes in the valve. However, they are rarely of clinical importance and may not progress to severe aortic regurgitation.