Signs of aortic regurgitation

1. SIGNS OF AORTIC REGURGITATION
Signs of wide pulse pressure :
· Light house sign - alternate flushing and blanching of forehead
· Landolfi's sign - change in pupillary size in accordance with cardiac cycle
· Becker's sign - retinal artery pulsations
· de Musset's sign - head bobbing with each heart beat
· Muller's sign - systolic pulsations of uvula
· Quincke's sign - capillary pulsations, detected by pressing a glass slide on patients lip or nail bed
· Corrigan's sign - dancing carotids
· Locomotor brachii
· Collapsing pulse - systolic pressure & diastolic pressure; but systolic > diastolic
· Pulsus bisferiens - double peaking in single systole
· Traube's sign - pistol shot femorals
· Duroziez s sign - proximal compression - systolic murmur over femoral artery
Distal compression with diaphragm of the stethoscope - diastolic murmur (Duroziez murmur)
· Hill's sign - popliteal cuff systolic pressure exceeds brachial cuff pressure by >20 mm Hg.
Mild AR - 20-40 mm Hg
Moderate AR - 40- 60 mm Hg1
Severe AR - > 60 mm Hg
·Rosenbach’s-sign - pulsations of liver
·Gerhardt’s sign - pulsations of spleen
· Other Signs:
Apical impulse displaced down and out ; hyper dynamic
Soft S1 (only in acute AR) ; S3 may be heard
Early diastolic murmur - high frequency, decrescendo; in left 3
rd
& 4
th
spaces with diaphragm of the stethoscope with
the patient leaning forwards, in expiration
Flow EDM across aortic valve heard at the heart base, conducted to carotids
Flow MDM across mitral valve (Austin-Flint murmur)- no loud S1 or opening snap unlike mitral stenosis
Severity of the lesion is indicated by:
a.Duration of murmur - if murmur > two thirds of diastole – murmur becomes holodiastolic & rough in quality
b. Bisferiens pulse
c. Positive Hill's sign > 60 mm Hg.
d. Apical impulse (down and out)
e. Austin-Flint murmur
f. Marked peripheral signs

2. Dr. chaitanya 2
nd
year PG