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25. Aortic Regurgitation 🫀 Internal Medicine | Cardiology | NEET-PG, FMGE, USMLE

Aortic regurgitation (AR), also called aortic insufficiency, is a condition where the aortic valve fails to close completely during diastole, causing blood to leak back from the aorta into the left ventricle. This leads to left ventricular volume overload, eccentric hypertrophy, and eventually left-sided heart failure. AR can be acute or chronic, each with distinct clinical presentations. The causes of AR include valvular diseases like rheumatic heart disease, infective endocarditis, and bicuspid aortic valve, as well as aortic root pathologies such as Marfan syndrome, aortic dissection, and syphilitic aortitis. Chronic AR may remain asymptomatic for years but can lead to exertional dyspnea, orthopnea, angina, and fatigue. Acute AR presents rapidly with pulmonary edema and hypotension due to sudden volume overload. Classic peripheral signs include Corrigan’s pulse, Quincke’s sign, De Musset’s sign, and Hill’s sign, all reflecting a wide pulse pressure. On auscultation, AR produces a high-pitched early diastolic decrescendo murmur at the left third intercostal space, best heard with the patient leaning forward and during expiration. Austin Flint murmur may also be heard due to regurgitant jet interfering with mitral valve closure. Echocardiography is the gold standard for diagnosis, showing regurgitant jet and assessing left ventricular function. Management includes medical therapy with vasodilators in mild to moderate cases, but aortic valve replacement (AVR) is indicated in symptomatic severe AR or when LVEF drops below 55% or LV end-systolic dimension exceeds 50 mm. Acute severe AR is a surgical emergency. Aortic regurgitation is high yield for NEET PG, FMGE, and USMLE, combining pathophysiology, dynamic physical signs, and precise surgical timing — a must-know for every medical student and clinician. #AorticRegurgitation #ValvularHeartDisease #CardiologySimplified #NEETPG2025 #FMGEPrep #USMLEReady #WaterHammerPulse #AustinFlintMurmur #HeartSounds #MBBSNotes #ClinicalMedicine #DoctorGoals #CardiologyLecture #WidePulsePressure #MedicalEducation