Aortic Regurgitation - Arrrrrgh!

Aortic Regurgitation - Arrrrrgh!
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(Hao Tran) #1

What is the AR murmur, how is it accentuated?

What is the Austin Flint, why does it sound different?

Gives at least 5 additional clinical signs of AR.


(Paul Lin) #2

What is the AR murmur, how is it accentuated?

  • high-pitched early diastolic murmur
  • best at the left sternal edge
  • leaning forward and breath held in expiration
    03%20pm

What is the Austin Flint, why does it sound different?

  • In severe AR, the regurgitant jet hits the anterior leaflet of the mitral
    valve, creating functional Mitral Stenosis (about 50% have this murmur)
  • Austin Flint is different as it is a low-pitched, mid-diastolic murmur at the apex (note this ‘MS’ murmur that occurs in AR, does not have the tapping apex or opening snap of classic MS murmurs)

Gives at least 5 additional clinical signs of AR.

Peripheral ‘bobbing’ signs

  • Collapsing ‘water hammer’ pulse
  • Wide pulse pressure (>50% of the systolic; e.g. 140/60 is wide)
  • Quincke’s sign (visible capillary pulsations in nailbed)
  • De Musset’s sign (head bobbing)
  • Corrigan’s sign (visible carotid pulsations)
  • Muller’s sign (uvula pulsations).