Acute Aortic Regurgitation

Aortic Intramural Hematoma and Its Complications

“…The degree of premature mitral valve closure has been correlated with the degree of increase in the left ventricular diastolic pressure. 13 Normally, the mitral valve does not close until shortly after the onset of left ventricular contraction, with leaflet closure occurring 40 ms after the onset of the QRS complex. Premature mitral valve closure is mild when there is complete coaptation of the anterior and posterior mitral leaflets at or before the initial inscription of the QRS (up to 50 ms before the Q wave and after the P wave).…”

“…Compared with patients with mild premature mitral valve closure, those with more severe premature mitral valve closure show greater elevations in left ventricular diastolic pressure and volume and may be marginally compensated. 13,14 IMH caused by PAU is also susceptible to complications of PAUs, including overt aortic dissection, pseudoaneurysm formation, and rupture into the pericardial sac leading to hemorrhagic pericardial or pleural effusion. 10 PAU is responsible for 2% to 7% of patients with acute aortic syndromes, and the rupture rate has been reported as high as 38% for PAUs presenting as acute aortic syndrome.…”

Etiology of Valvular Heart Disease in the 21st Century

“…The pathophysiology and clinical presentation in acute valve regurgitation is different from that of chronic regurgitation. In acute VHD, depending on the severity of the lesion and hemodynamic consequences, emergency surgery may be necessary [1,2,3,56,57]. …”

Native and Prosthetic Valve Emergencies

“…16 Early mortality in patients with acute AR secondary to aortic dissection has been reported to be as much as 1% to 2% per hour. 17 Medical intervention with dobutamine and nitroprusside to try to enhance forward output may be of some assistance on the way to the operating room, but are no substitute for surgical intervention. The use of beta blockers for control of tachycardia in patients with acute AR is relatively contraindicated as the reduced diastolic filling associated with tachycardia serves to reduce the overall regurgitant volume.…”