Aortic regurgitation: Difference between revisions
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*Reduce afterload | *Reduce afterload | ||
**[[Nitroprusside]] | **[[Nitroprusside]] | ||
*Inotropic support | |||
**[[Dobutamine]] | |||
*Diuretics and nitrates do ''not'' work | *Diuretics and nitrates do ''not'' work | ||
*Do ''not'' use β-blockers (block compensatory tachycardia) | *Do ''not'' use β-blockers (block compensatory tachycardia) | ||
Revision as of 20:35, 10 February 2021
Background
Causes
- Endocarditis
- Aortic dissection
- Always suspect in acute aortic regurgitation
- Blunt chest trauma
Clinical Features
- Pulmonary edema
- Wide pulse pressure
- Dyspnea
- Hypotension (may progress to cardiogenic shock)
- Decrescendo diastolic murmur heard immediately after S2
Differential Diagnosis
Valvular Emergencies
Evaluation
Consider the following tests
- CXR may be helpful
- May see pulmonary edema with out cardiac enlargement
- Left ventricular hypertrophy and dilated aorta
- Transthoracic echo will provide a more definitive diagnosis
Management
- Immediate surgical intervention
- Reduce afterload
- Inotropic support
- Diuretics and nitrates do not work
- Do not use β-blockers (block compensatory tachycardia)