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Assessing severity of aortic regurgitation

Severity of aortic regurgitation can be assessed with the following.
1.    Murmur duration. Duration of murmur is directly proportional to the severity of AR (>2/3 diastole). In moderate to severe AR mumur is holodiastolic.
2.    Hill Sign
          Mild : < 40 mmHg
          Moderate : 40 – 60 mmHg
          Severe : > 60 mmHg
Hills sign is the difference in blood pressure between the upper limb and lower limb.
3.    Austin flint murmur is heard in severe MR.
4.    Down and out apical impulse.
5.    Marked peripheral signs of AR.
          Heart failure lead to erroneous judgement of severity of AR due to peripheral vasoconstriction. So severely should be reassessed after correction of heart failure.