Aortic regurgitation

From Citizendium, the Citizens' Compendium
Jump to: navigation, search
This article is developing and not approved.
Main Article
Talk
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and not meant to be cited; by editing it you can help to improve it towards a future approved, citable version. These unapproved articles are subject to a disclaimer.

Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle.

Diagnosis

A systematic review by the Rational Clinical Examination concluded that "Clinical examination by cardiologists is accurate for detecting AR, but not enough is known about the examinations of less-expert clinicians".[1]

Treatment

Medications

The role of vasodilator therapy is uncertain with conflicting studies. A randomized controlled trial found that nifedipine 20 mg twice daily "reduces or delays the need for aortic-valve replacement in asymptomatic patients with severe aortic regurgitation and normal left ventricular systolic function."[2] However, a more recent placebo-controlled randomized controlled trial concluded that nifedipine 20 mg every 12 hours or enalapril 20 mg per day "did not reduce or delay the need for aortic-valve replacement in patients with asymptomatic severe aortic regurgitation and normal left ventricular systolic function."[3]

References

  1. Choudhry NK, Etchells EE (1999). "The rational clinical examination. Does this patient have aortic regurgitation?". JAMA 281 (23): 2231–8. PMID 10376577[e]
  2. Scognamiglio R, Rahimtoola SH, Fasoli G, Nistri S, Dalla Volta S (1994). "Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function". N. Engl. J. Med. 331 (11): 689–94. PMID 8058074[e]
  3. Evangelista A, Tornos P, Sambola A, Permanyer-Miralda G, Soler-Soler J (2005). "Long-term vasodilator therapy in patients with severe aortic regurgitation". N. Engl. J. Med. 353 (13): 1342–9. DOI:10.1056/NEJMoa050666. PMID 16192479. Research Blogging.