Describe the heart sounds in aortic regurgitation
First heart sound (S1)
Intensity of S1 is usually decreased, it is due
to the partial closure of mitral valve
leaflet in presystole. It indicates that the aortic regurgitation is of moderate
to severe intensity.
If the patient has loud S1 – think of
coexisting mitral stenosis.
Comment
on the A2 in AR
A2 is usually variable.
Loud A2 is due to aortic root dilatation.
Soft A2 - is produced due to low ability of valve leafet to vibrate after the aortic
valve closure.
Describe
the split in AR
Split may be normal, single S2 or prodoxically
split.
What
is the significance of S3 in AR
Occur in AR due to
increased LVEDV (Left ventricular end diastolic volume). Left ventricular
dysfunction can also cause LVS3.
LVS3 is commonly associated with Austin – flint murmur and
peripheral signs of aortic regurgitation.
What
is the significance of S4 in AR
Seen usually in severe AR.
What
is the significance of Aortic ejection click in AR
1. Seen
in patients with mild AR with normal LV function.
2. Valvular
Ejection Click – is due to bicuspid aortic valve.
3. Vascular
ejection click– is due to Aortic root dilatation.
