Materiały źródłowe

• #1 Aortic valve regurgitation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-regurgitation/symptoms-causes/syc-20353129

  In aortic valve regurgitation, the aortic valve doesn’t close properly. This causes blood to flow backward from the body’s main artery, called the aorta, into the lower left heart chamber, called the left ventricle. […] Aortic valve regurgitation can develop suddenly or over many years. Once the condition becomes severe, surgery often is needed to repair or replace the valve. […] Call a member of your health care team right away if you have symptoms of aortic valve regurgitation. […] Make an appointment with your health care team if you have: Tiredness, also called fatigue, that doesn’t get better with rest. […] Early diagnosis of heart valve disease, such as aortic valve regurgitation, is important. Doing so may make the condition easier to treat.

• #2 Aortic Regurgitation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24396-aortic-regurgitation

  Aortic regurgitation describes an aortic valve (between your main artery and main pumping chamber) that doesnt close tightly. Blood leaks backward with each heartbeat. […] Healthcare providers diagnose aortic valve regurgitation through a physical exam and testing. […] A wide pulse pressure (40+ mmHg) could mean a leaky aortic valve. […] An echocardiogram (echo) is the gold standard for diagnosing aortic regurgitation. This test uses high-frequency sound waves (ultrasound) to take pictures of your heart. Your provider can use different techniques, like Doppler ultrasound, to check your valve function. […] Depending on the severity of your condition, you may need surgery to repair or replace your aortic valve. Your healthcare provider will evaluate you and decide if you need surgery.

• #3 Aortic valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-regurgitation/diagnosis-treatment/drc-20353135

  To diagnose aortic valve regurgitation, a member of your health care team examines you. You usually are asked questions about your symptoms and health history. You also might be asked about your family’s health history. […] Your health care professional may hear an irregular sound called a heart murmur. […] Tests may be done to check your heart health and learn the cause of aortic valve regurgitation. […] An echocardiogram can help tell how severe aortic regurgitation is. […] If a standard test doesn’t provide enough information, you may have one called a transesophageal echocardiogram. […] Cardiac catheterization may be done before valve replacement surgery to check for blockages. […] After testing confirms a diagnosis of heart valve disease, your health care team may tell you the stage of disease.

• #4 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  If you think you could have aortic regurgitation, a heart condition that causes leaking of the aortic valve, consult your physician for an evaluation. Theyll perform an exam and a series of diagnostic tests to determine if you have the disease. […] Diagnosing aortic regurgitation involves evaluating your heart, running tests to confirm the diagnosis, and developing a management plan. […] After viewing your medical and family history, your physician will perform a physical exam to check for signs of aortic regurgitation. This includes listening to your heart for irregular heartbeats (palpitations) or murmurs that may indicate abnormalities. […] Your physician will also evaluate risk factors, such as genetics and high blood pressure. Theyll gather all this data to determine if further diagnostic testing is needed.

• #5 Aortic Regurgitation Exam | Stanford Medicine 25 | Stanford Medicine

  https://stanfordmedicine25.stanford.edu/the25/aorticregurgitation.html

  When done properly the physical exam can not only allow us to make a diagnosis of aortic regurgitation, but also help determine its specific causes and the presence of complications like systolic and diastolic heart failure. […] The physical exam is crucial for the diagnosis of aortic regurgitation and also for the identification of its causes and possible complications like heart failure. […] Auscultation is the most important part of the physical exam for aortic regurgitation. […] The characteristic murmur of aortic regurgitation, early diastolic louder at the left lower sternal border, has a positive Likelihood Ratio of 9.9 for the diagnosis of mild or more severe aortic regurgitation. […] In a patient with aortic regurgitation the heart has to increase the stroke volume in order to keep the cardiac output constant.

• #6 Aortic Valve Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542205/

  An in-depth history and thorough physical exam are essential and commonly the first line of diagnosis for aortic valvulopathy. Symptoms of aortic stenosis or regurgitation often are not present or are too mild for the patient to notice until the pathology has become severe. […] A systolic ejection murmur can often be heard best over the right sternal border at the second intercostal space for aortic stenosis. […] When acute or severe, aortic regurgitation can be suspected when the patient has a wide pulse pressure, and a low-pitched early diastolic murmur is auscultated again over the right sternal border at the second intercostal space. […] Valve replacement for aortic stenosis is recommended for asymptomatic patients (evidenced by history or stress testing) with a high-gradient disease or asymptomatic patients with severe aortic stenosis (C2) and a left ventricular ejection fraction less than 50%.

• #7 Aortic Valve Insufficiency: Causes, Symptoms & Diagnosis

  https://www.healthline.com/health/aortic-insufficiency

  Aortic valve regurgitation happens when your aortic valve doesnt fully close, causing some blood to remain in your left ventricle. It can cause symptoms like chest pain and fatigue, among others. […] During the office exam, a doctor will take a complete medical history. Theyll also listen to your heart, review your pulse and blood pressure, and look for indicators of heart valve problems, such as: an unusually forceful heartbeat, visible pulsing of the neck artery, a water-hammer pulse, which is a pounding pulse thats typical of aortic insufficiency, sounds of blood leaking from the aortic valve. […] They may also order additional tests to accurately diagnose the cause of your symptoms. These tests can include: chest X-ray to spot enlargement of the left ventricle, which is typical of heart disease, electrocardiogram (EKG) to measure the electrical activity of the heart, including the rate and regularity of heartbeats, an echocardiogram to view the condition of the heart chambers and heart valves, cardiac catheterization to assess the pressure and flow of blood through the heart chambers, other imaging tests, such as a CT scan, heart MRI, and coronary angiography. […] These tests allow a doctor to confirm the diagnosis, determine the extent of damage, and decide on the most appropriate treatment.

• #8 Aortic Regurgitation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24396-aortic-regurgitation

  Aortic regurgitation describes an aortic valve (between your main artery and main pumping chamber) that doesnt close tightly. Blood leaks backward with each heartbeat. […] Healthcare providers diagnose aortic valve regurgitation through a physical exam and testing. […] A wide pulse pressure (40+ mmHg) could mean a leaky aortic valve. […] An echocardiogram (echo) is the gold standard for diagnosing aortic regurgitation. This test uses high-frequency sound waves (ultrasound) to take pictures of your heart. Your provider can use different techniques, like Doppler ultrasound, to check your valve function. […] Depending on the severity of your condition, you may need surgery to repair or replace your aortic valve. Your healthcare provider will evaluate you and decide if you need surgery.

• #9 Aortic Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/aortic-regurgitation

  Aortic regurgitation (AR) is incompetency of the aortic valve causing backflow from the aorta into the left ventricle during diastole. […] Diagnosis is by physical examination and echocardiography. […] Diagnosis of aortic regurgitation is suspected based on history and physical examination findings and confirmed by echocardiography. Doppler echocardiography is the test of choice to detect and quantify the magnitude of regurgitant blood flow and grade overall severity of the AR. […] Echocardiography can also assess severity of pulmonary hypertension secondary to LV failure, detect vegetations or pericardial effusions (eg, in aortic dissection), and provide information about prognosis. […] ECG and chest x-ray should be done. […] Chest x-ray may show cardiomegaly and a prominent aortic root in patients with chronic progressive AR. […] Coronary angiography should be done before surgery, even if no angina is present because about 20% of patients with severe AR have significant coronary artery disease, which may need concomitant coronary artery bypass graft surgery.

• #10 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Aortic regurgitation (AR) may occur due to damage to the aortic valve leaflets or as a result of dilation of the aortic annulus. […] Transthoracic echocardiography (TTE) is the preferred diagnostic modality for aortic regurgitation. Almost 100% sensitive and specific for the detection of aortic regurgitation, TTE is also crucial in determining etiology and estimating severity. […] Color flow Doppler echo permits direct visualization of the regurgitant jet. This is extremely important in patients with acute AR when stroke volume is compromised. […] In addition to the regurgitant jet, echo examination demonstrates structural abnormalities, such as a bicuspid aortic valve or cusp prolapse. […] Two classification systems for chronic aortic regurgitation are currently in widespread use: the American Society of Echocardiography grading system and the American College of Cardiology/American Heart Association staging system.

• #11 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Aortic regurgitation (AR) may occur due to damage to the aortic valve leaflets or as a result of dilation of the aortic annulus. […] Transthoracic echocardiography (TTE) is the preferred diagnostic modality for aortic regurgitation. Almost 100% sensitive and specific for the detection of aortic regurgitation, TTE is also crucial in determining etiology and estimating severity. […] Color flow Doppler echo permits direct visualization of the regurgitant jet. This is extremely important in patients with acute AR when stroke volume is compromised. […] In addition to the regurgitant jet, echo examination demonstrates structural abnormalities, such as a bicuspid aortic valve or cusp prolapse. […] Two classification systems for chronic aortic regurgitation are currently in widespread use: the American Society of Echocardiography grading system and the American College of Cardiology/American Heart Association staging system.

• #12 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A transthoracic echocardiogram is a non-invasive ultrasound of the heart that evaluates the hearts structure and function. By placing an ultrasound probe on the chest, soundwaves are used to assess blood flow through the heart and valves. The data from the TTE helps determine the severity of aortic regurgitation. […] Like a TTE, the transesophageal echocardiogram uses ultrasound waves to create detailed images of the hearts structures. However, instead of placing the probe on the chest, a TEE involves inserting the ultrasound probe into the esophagus. This approach provides a more detailed view of the heart, aorta, and surrounding tissues. […] Electrocardiograms record your hearts electrical activity and detect abnormalities like arrhythmias. In cases of aortic valve regurgitation, an EKG can identify left ventricle hypertrophy (thickening of the heart wall) and other underlying heart issues, such as myocardial ischemia.

• #13 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Aortic regurgitation (AR) may occur due to damage to the aortic valve leaflets or as a result of dilation of the aortic annulus. […] Transthoracic echocardiography (TTE) is the preferred diagnostic modality for aortic regurgitation. Almost 100% sensitive and specific for the detection of aortic regurgitation, TTE is also crucial in determining etiology and estimating severity. […] Color flow Doppler echo permits direct visualization of the regurgitant jet. This is extremely important in patients with acute AR when stroke volume is compromised. […] In addition to the regurgitant jet, echo examination demonstrates structural abnormalities, such as a bicuspid aortic valve or cusp prolapse. […] Two classification systems for chronic aortic regurgitation are currently in widespread use: the American Society of Echocardiography grading system and the American College of Cardiology/American Heart Association staging system.

• #14 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Aortic regurgitation (AR) may occur due to damage to the aortic valve leaflets or as a result of dilation of the aortic annulus. […] Transthoracic echocardiography (TTE) is the preferred diagnostic modality for aortic regurgitation. Almost 100% sensitive and specific for the detection of aortic regurgitation, TTE is also crucial in determining etiology and estimating severity. […] Color flow Doppler echo permits direct visualization of the regurgitant jet. This is extremely important in patients with acute AR when stroke volume is compromised. […] In addition to the regurgitant jet, echo examination demonstrates structural abnormalities, such as a bicuspid aortic valve or cusp prolapse. […] Two classification systems for chronic aortic regurgitation are currently in widespread use: the American Society of Echocardiography grading system and the American College of Cardiology/American Heart Association staging system.

• #15 Aortic valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-regurgitation/diagnosis-treatment/drc-20353135

  To diagnose aortic valve regurgitation, a member of your health care team examines you. You usually are asked questions about your symptoms and health history. You also might be asked about your family’s health history. […] Your health care professional may hear an irregular sound called a heart murmur. […] Tests may be done to check your heart health and learn the cause of aortic valve regurgitation. […] An echocardiogram can help tell how severe aortic regurgitation is. […] If a standard test doesn’t provide enough information, you may have one called a transesophageal echocardiogram. […] Cardiac catheterization may be done before valve replacement surgery to check for blockages. […] After testing confirms a diagnosis of heart valve disease, your health care team may tell you the stage of disease.

• #16 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A transthoracic echocardiogram is a non-invasive ultrasound of the heart that evaluates the hearts structure and function. By placing an ultrasound probe on the chest, soundwaves are used to assess blood flow through the heart and valves. The data from the TTE helps determine the severity of aortic regurgitation. […] Like a TTE, the transesophageal echocardiogram uses ultrasound waves to create detailed images of the hearts structures. However, instead of placing the probe on the chest, a TEE involves inserting the ultrasound probe into the esophagus. This approach provides a more detailed view of the heart, aorta, and surrounding tissues. […] Electrocardiograms record your hearts electrical activity and detect abnormalities like arrhythmias. In cases of aortic valve regurgitation, an EKG can identify left ventricle hypertrophy (thickening of the heart wall) and other underlying heart issues, such as myocardial ischemia.

• #17 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Aortic regurgitation (AR) may occur due to damage to the aortic valve leaflets or as a result of dilation of the aortic annulus. […] Transthoracic echocardiography (TTE) is the preferred diagnostic modality for aortic regurgitation. Almost 100% sensitive and specific for the detection of aortic regurgitation, TTE is also crucial in determining etiology and estimating severity. […] Color flow Doppler echo permits direct visualization of the regurgitant jet. This is extremely important in patients with acute AR when stroke volume is compromised. […] In addition to the regurgitant jet, echo examination demonstrates structural abnormalities, such as a bicuspid aortic valve or cusp prolapse. […] Two classification systems for chronic aortic regurgitation are currently in widespread use: the American Society of Echocardiography grading system and the American College of Cardiology/American Heart Association staging system.

• #18 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  The pressure half-time index is the time it takes for the initial maximal pressure gradient in diastole to fall by 50%. […] The vena contracta is the narrowest portion of the regurgitant flow that occurs at or immediately after (downstream of) the regurgitant orifice (in the case of aortic regurgitation, the aortic valve). […] Regurgitant volume (RVol) per beat, which can be calculated as the difference between the stroke volume though the affected valve and stroke volume through a competent valve (among other methods), is a measure of volume overload severity. […] Effective regurgitant orifice area (EROA) is considered a fundamental measure of lesion severity. […] It is important to note that the severity of aortic regurgitation assessed using echocardiography is dependent on the hemodynamic status of the patient at the time of the evaluation most importantly, the afterload.

• #19 Aortic regurgitation – Echocardiography, diagnosis, grading, severity

  https://ecgwaves.com/topic/aortic-valve-regurgitation/

  Aortic regurgitation implies that the aortic valve leaks during diastole, such that blood regurgitates back from the aorta into the left ventricle. This results in volume overload in the left ventricle during diastole. The hemodynamic consequences of aortic regurgitation depend on whether the condition develops acutely or gradually. […] The severity of aortic regurgitation can be evaluated using the following parameters. […] A normal-sized ventricle with hyperdynamic contractility suggests acute aortic regurgitation. […] It is important to note that the estimated severity of aortic regurgitation depends on the hemodynamic circumstances; severity is overestimated in patients with a significantly increased LVEDP. […] EROA 0.1 cm2 suggests mild aortic regurgitation. If EROA is 0.3 cm2, then the regurgitation is severe. […] Regurgitation volume 30 ml/stroke implies that aortic regurgitation is moderate. Regurgitation volume 60 ml/stroke is classified as severe aortic regurgitation.

• #20 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/4/

  The echocardiographic minimum dataset for aortic regurgitation consists of: […] A useful method for confirming the presence of severe aortic regurgitation is the assessment of flow within the proximal descending aorta. The detection of pandiastolic flow reversal with an end diastolic flow velocity of 20 cm/s is a sensitive sign of significant aortic regurgitation. […] Other methods used are the regurgitant volume and also regurgitant fraction by either pulsed Doppler or by the proximal isovelocity surface area method. A regurgitant volume of 60 mls and a regurgitant fraction of 50% are taken to be indicative of severe aortic regurgitation. […] Aortic regurgitation is identified by diastolic reverse flow into the LVOT on SSFP cine imaging in the 3-chamber/LVOT view. […] Accurate quantification of regurgitant volume and fraction can be obtained using in-plane flow imaging that is able to measure both the forward flow and the regurgitant flow across the aortic valve. […] There is evidence that regurgitant fraction by CMR better predicts risk than echo measures.

• #21 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  The pressure half-time index is the time it takes for the initial maximal pressure gradient in diastole to fall by 50%. […] The vena contracta is the narrowest portion of the regurgitant flow that occurs at or immediately after (downstream of) the regurgitant orifice (in the case of aortic regurgitation, the aortic valve). […] Regurgitant volume (RVol) per beat, which can be calculated as the difference between the stroke volume though the affected valve and stroke volume through a competent valve (among other methods), is a measure of volume overload severity. […] Effective regurgitant orifice area (EROA) is considered a fundamental measure of lesion severity. […] It is important to note that the severity of aortic regurgitation assessed using echocardiography is dependent on the hemodynamic status of the patient at the time of the evaluation most importantly, the afterload.

• #22 Chronic aortic regurgitation: diagnosis and therapy in the modern era

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/chronic-aortic-regurgitation-diagnosis-and-therapy-in-the-modern-era

  Aortic regurgitation (AR) is a complex and multifactorial valvular disease. A comprehensive evaluation by echocardiography should follow a multiparametric approach and the interpretation based on all the information collected during the examination, including the underlying valve pathology. […] When different echocardiographic parameters are discordant and conflicts cannot be resolved, multimodality imaging including cardiac magnetic resonance is warranted. […] Transthoracic echocardiography (TTE) is the first-line imaging modality for the diagnosis of AV disease including the assessment of the aortic root and proximal ascending aorta. […] Cardiac magnetic resonance (CMR) is an accurate and reproducible imaging modality with increasing availability that serves as an additional diagnostic tool for assessment of AR severity and quantification of LV remodelling.

• #23 Chronic aortic regurgitation: diagnosis and therapy in the modern era

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/chronic-aortic-regurgitation-diagnosis-and-therapy-in-the-modern-era

  The measurement of pressures and cardiac output by cardiac catheterisation or the assessment of valvular regurgitation by aortography is restricted to situations where echocardiographic evaluation is inconclusive or discordant with clinical findings and other non-invasive imaging modalities such as CMR are contraindicated or not available. […] An additional reasonable indication for CMR is detection of replacement or reactive fibrosis. […] However, no single echocardiographic parameter can accurately grade the severity of AR because of geometric assumptions, technical limitations, and variable haemodynamic conditions. […] When the evidence from the different parameters is congruent, it is easy to grade AR severity. […] When different echocardiographic parameters are contradictory, inconclusive or discordant with the clinical assessment, CMR may play a useful role in grading AR severity and assessing LV remodelling.

• #24 Aortic Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557428/

  In aortic insufficiency patients with little to no symptoms, exercise stress testing can assess the presence of symptoms and their functional capacity. […] Cardiac MRI has a class 1 indication in stage B, C, and D moderate to severe chronic aortic insufficiency patients when suboptimal information is obtained from echocardiography, or the information obtained is discordant with clinical information. […] Surgical management of aortic insufficiency is the gold standard for correcting aortic insufficiency, and the implementation of TAVR is influencing post-surgical outcomes. […] It is important to consider additional and alternative conditions that can be mistaken or overlooked when diagnosing aortic insufficiency. […] Prognosis is dependent on the onset of symptoms and the progressions of the patient’s aortic insufficiency.

• #25 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A CT scan provides images of the aortic valve and surrounding structures. This test helps identify abnormalities such as valve calcification or a bicuspid aortic valve. […] A chest X-ray wont precisely determine if you have aortic valve regurgitation, but it can identify information about your hearts condition. […] A stress test measures your hearts functioning during physical activity. […] This procedure can evaluate blood flow, measure pressures inside the heart, and check for coronary artery blockages that could impact treatment decisions for aortic valve regurgitation. […] Whether you require aortic valve leakage treatment depends on factors like your symptoms, the underlying cause, the severity of the regurgitation, and your overall health. […] Mild aortic regurgitation is often managed with medication and regular monitoring through periodic echocardiograms. However, more severe cases may require aortic valve regurgitation surgery.

• #26 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A CT scan provides images of the aortic valve and surrounding structures. This test helps identify abnormalities such as valve calcification or a bicuspid aortic valve. […] A chest X-ray wont precisely determine if you have aortic valve regurgitation, but it can identify information about your hearts condition. […] A stress test measures your hearts functioning during physical activity. […] This procedure can evaluate blood flow, measure pressures inside the heart, and check for coronary artery blockages that could impact treatment decisions for aortic valve regurgitation. […] Whether you require aortic valve leakage treatment depends on factors like your symptoms, the underlying cause, the severity of the regurgitation, and your overall health. […] Mild aortic regurgitation is often managed with medication and regular monitoring through periodic echocardiograms. However, more severe cases may require aortic valve regurgitation surgery.

• #27 Aortic Regurgitation: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/aortic-regurgitation

  How Is Aortic Regurgitation Diagnosed? […] Even if you dont have symptoms, your doctor may be able to detect aortic regurgitation by listening to your heart with a stethoscope. […] If they suspect aortic regurgitation, your doctor may order one or more of the following tests: […] Echocardiogram: Sound waves aimed at your heart create a video of it as it beats. This imaging test can help find aortic regurgitation and determine how seriously its interfering with healthy blood flow. […] Chest X-ray: This can often tell if your heart is enlarged, possibly because of aortic regurgitation. An X-ray can also show whether your lungs have been affected by blood backing up in your heart. […] Cardiac catheterization: Your doctor will do this test to see how bad your aortic regurgitation is. Theyll insert a flexible tube called a catheter through an artery and into your heart. They may also use special dye and an X-ray movie to get a more detailed look at your hearts valves and chambers.

• #28 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Cardiac catheterization with aortography and hemodynamic measurements is no longer necessary in the majority of patients with aortic regurgitation because of the accuracy of TTE. […] In addition to cardiac catheterization, other diagnostic modalities such as TEE and cardiac magnetic resonance (CMR) imaging may be a useful supplement to TTE in the diagnostic process.

• #29 Aortic Regurgitation Workup: Approach Considerations, Imaging for Aortic Regurgitation, Electrocardiography

  https://emedicine.medscape.com/article/150490-workup

  Standard chest radiography may show evidence of structural abnormalities (aortic dilation, prosthetic valve dislodgement, aortic valvular calcification) or functional compromise (pulmonary edema, cardiomegaly). […] Aortic angiography, which may be performed during a cardiac catheterization procedure, may provide useful information regarding the severity of the patient’s AR. […] Cardiac catheterization is not always required in all patients with chronic AR but may provide extremely valuable clinical information, especially in patients who are contemplating surgery. Indications for cardiac catheterization include the following: Assessment of coronary anatomy prior to aortic valve surgery in patients with risk factors for coronary artery disease; Assessment of severity of AR, LV function, or aortic root size when noninvasive tests are inconclusive or are discordant with clinical findings.

• #30 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A transthoracic echocardiogram is a non-invasive ultrasound of the heart that evaluates the hearts structure and function. By placing an ultrasound probe on the chest, soundwaves are used to assess blood flow through the heart and valves. The data from the TTE helps determine the severity of aortic regurgitation. […] Like a TTE, the transesophageal echocardiogram uses ultrasound waves to create detailed images of the hearts structures. However, instead of placing the probe on the chest, a TEE involves inserting the ultrasound probe into the esophagus. This approach provides a more detailed view of the heart, aorta, and surrounding tissues. […] Electrocardiograms record your hearts electrical activity and detect abnormalities like arrhythmias. In cases of aortic valve regurgitation, an EKG can identify left ventricle hypertrophy (thickening of the heart wall) and other underlying heart issues, such as myocardial ischemia.

• #31 Aortic Regurgitation Workup: Approach Considerations, Imaging for Aortic Regurgitation, Electrocardiography

  https://emedicine.medscape.com/article/150490-workup

  Echocardiographic assessment of AR following TAVR is much more challenging because the AR is usually paravalvular and occurs in the context of acute hemodynamic changes, as well as prosthetic materials that may impair image quality. […] Proposed TEE criteria for identifying significant AR include a regurgitant jet extending below the LV outflow tract, multiple AR jets, holodiastolic flow reversal in the descending aorta, and circumferential extent of the jet in short axis (10% moderate, 30% severe). […] Exercise treadmill testing may be used to guide recommendations for surgical therapy in patients with severe chronic AR and equivocal symptoms. […] However, the role of stress echocardiography in patients with AR remains uncertain, and further studies may be needed before it can be recommended for routine clinical use.

• #32 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A CT scan provides images of the aortic valve and surrounding structures. This test helps identify abnormalities such as valve calcification or a bicuspid aortic valve. […] A chest X-ray wont precisely determine if you have aortic valve regurgitation, but it can identify information about your hearts condition. […] A stress test measures your hearts functioning during physical activity. […] This procedure can evaluate blood flow, measure pressures inside the heart, and check for coronary artery blockages that could impact treatment decisions for aortic valve regurgitation. […] Whether you require aortic valve leakage treatment depends on factors like your symptoms, the underlying cause, the severity of the regurgitation, and your overall health. […] Mild aortic regurgitation is often managed with medication and regular monitoring through periodic echocardiograms. However, more severe cases may require aortic valve regurgitation surgery.

• #33 Aortic valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-regurgitation/diagnosis-treatment/drc-20353135

  To diagnose aortic valve regurgitation, a member of your health care team examines you. You usually are asked questions about your symptoms and health history. You also might be asked about your family’s health history. […] Your health care professional may hear an irregular sound called a heart murmur. […] Tests may be done to check your heart health and learn the cause of aortic valve regurgitation. […] An echocardiogram can help tell how severe aortic regurgitation is. […] If a standard test doesn’t provide enough information, you may have one called a transesophageal echocardiogram. […] Cardiac catheterization may be done before valve replacement surgery to check for blockages. […] After testing confirms a diagnosis of heart valve disease, your health care team may tell you the stage of disease.

• #34 Chronic aortic regurgitation: diagnosis and therapy in the modern era

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/chronic-aortic-regurgitation-diagnosis-and-therapy-in-the-modern-era

  The ESC guidelines also suggest reporting the indexed LV end-systolic dimensions (ESD) to accurately identify chamber enlargement in individuals with small body size, specifically in women and elderly patients because non-indexed dimensions are less likely to meet surgical indications in this cohort. […] The two surgical treatment options include AV replacement (using biological tissue or mechanical valve prostheses) or AV repair.

• #35 Aortic Regurgitation

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-regurgitation

  Cardiac catheterization with aortography and hemodynamic measurements is no longer necessary in the majority of patients with aortic regurgitation because of the accuracy of TTE. […] In addition to cardiac catheterization, other diagnostic modalities such as TEE and cardiac magnetic resonance (CMR) imaging may be a useful supplement to TTE in the diagnostic process.

• #36 Aortic Regurgitation: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24396-aortic-regurgitation

  If valve surgery isnt a good option for you, your provider may prescribe medications to manage heart failure and improve your quality of life. […] Regular visits are essential so your provider can catch signs of worsening aortic regurgitation. This allows you to receive treatment at the right time and avoid permanent damage to your heart.

• #37 Aortic Regurgitation | Doctor

  https://patient.info/doctor/aortic-regurgitation-pro

  If left ventricular diameter and/or ejection fraction show significant changes, or become close to the threshold for intervention, follow-up should be continued at six-monthly intervals. […] In patients with a dilated aorta, especially in patients with Marfan’s syndrome or with a bicuspid valve, echocardiography should be performed on a yearly basis. […] Indications for surgery: Symptomatic patients. […] Asymptomatic patients should also be operated on when left ventricular function begins to deteriorate (LVEF 55%) or when end systolic diameter is 50 mm or end systolic diameter index is 24 mm2 on echocardiography, since the likelihood of developing irreversible myocardial dysfunction is high if intervention is delayed. […] Treatment of isolated AR has traditionally been by valve replacement.

• #38 Aortic Regurgitation | Doctor

  https://patient.info/doctor/aortic-regurgitation-pro

  If left ventricular diameter and/or ejection fraction show significant changes, or become close to the threshold for intervention, follow-up should be continued at six-monthly intervals. […] In patients with a dilated aorta, especially in patients with Marfan’s syndrome or with a bicuspid valve, echocardiography should be performed on a yearly basis. […] Indications for surgery: Symptomatic patients. […] Asymptomatic patients should also be operated on when left ventricular function begins to deteriorate (LVEF 55%) or when end systolic diameter is 50 mm or end systolic diameter index is 24 mm2 on echocardiography, since the likelihood of developing irreversible myocardial dysfunction is high if intervention is delayed. […] Treatment of isolated AR has traditionally been by valve replacement.

• #39 Chronic aortic regurgitation: diagnosis and therapy in the modern era

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/chronic-aortic-regurgitation-diagnosis-and-therapy-in-the-modern-era

  The measurement of pressures and cardiac output by cardiac catheterisation or the assessment of valvular regurgitation by aortography is restricted to situations where echocardiographic evaluation is inconclusive or discordant with clinical findings and other non-invasive imaging modalities such as CMR are contraindicated or not available. […] An additional reasonable indication for CMR is detection of replacement or reactive fibrosis. […] However, no single echocardiographic parameter can accurately grade the severity of AR because of geometric assumptions, technical limitations, and variable haemodynamic conditions. […] When the evidence from the different parameters is congruent, it is easy to grade AR severity. […] When different echocardiographic parameters are contradictory, inconclusive or discordant with the clinical assessment, CMR may play a useful role in grading AR severity and assessing LV remodelling.

• #40 Chronic aortic regurgitation: diagnosis and therapy in the modern era

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/chronic-aortic-regurgitation-diagnosis-and-therapy-in-the-modern-era

  The measurement of pressures and cardiac output by cardiac catheterisation or the assessment of valvular regurgitation by aortography is restricted to situations where echocardiographic evaluation is inconclusive or discordant with clinical findings and other non-invasive imaging modalities such as CMR are contraindicated or not available. […] An additional reasonable indication for CMR is detection of replacement or reactive fibrosis. […] However, no single echocardiographic parameter can accurately grade the severity of AR because of geometric assumptions, technical limitations, and variable haemodynamic conditions. […] When the evidence from the different parameters is congruent, it is easy to grade AR severity. […] When different echocardiographic parameters are contradictory, inconclusive or discordant with the clinical assessment, CMR may play a useful role in grading AR severity and assessing LV remodelling.

• #41 Aortic valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-regurgitation/diagnosis-treatment/drc-20353135

  The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] If you have aortic valve regurgitation, consider being cared for by a medical team that specializes in heart valve disease. […] For aortic valve regurgitation, questions to ask your health care team include: What tests do I need? […] Don’t hesitate to ask any other questions.

• #42 Aortic Regurgitation | Edwards Lifesciences

  https://www.edwards.com/healthcare-professionals/conditions-procedures/aortic-regurgitation

  Echocardiography is the initial method of AR evaluation9-11 […] Multiple echocardiographic parameters are required to precisely quantify AR.11 Transthoracic echocardiography (TTE) is an essential first diagnostic test, and measurements obtained are frequently sufficient to evaluate the presence and severity of AR.9, 11 […] Despite the class 1 indication for SAVR, most patients with ssAR do not receive treatment within one year12 […] An adjusted analysis showed patients who underwent SAVR had a 62% reduction in risk of 1-year mortality compared to patients who did not undergo surgery.12 […] All patients with severe valvular heart disease being considered for valve intervention should be evaluated by a multidisciplinary team with either referral to or consultation with a primary or comprehensive valve center.9

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