Acute native aortic regurgitation: clinical presentation, diagnosis and management

Voit, Jay; Otto, Catherine M; Burke, Christopher R.

doi:10.1136/heartjnl-2021-320157

Cited by 4 publications

(5 citation statements)

References 52 publications

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“…However, with the pathological development of AMR, the LV communicates concurrently with the high-pressure aorta and the low-pressure LA. As the volume of blood flow is proportional to the pressure gradient between two the cardiac chambers and tends to flow in the path of least resistance, the bulk of the LV stroke volume flows backwards in preference of the low-pressure LA to the high-pressure aorta, subsequently compromising forward systemic flow [7,8,24]. Similarly, with AAR, the regurgitant volume from the aorta into a non-compliant LV leads to a sudden rise in LV pressure during diastole, leading to the degradation of the diastolic pressure gradient between LA and LV.…”

Section: Acute Severe Left-sided Valve Incompetencementioning

confidence: 99%

“…Similarly, with AAR, the regurgitant volume from the aorta into a non-compliant LV leads to a sudden rise in LV pressure during diastole, leading to the degradation of the diastolic pressure gradient between LA and LV. This in turn compromises diastolic LV filling and reduces cardiac output [3,8].…”

Section: Acute Severe Left-sided Valve Incompetencementioning

confidence: 99%

“…Acute left-sided native cardiac valvular dysfunction, specifically acute severe mitral regurgitation (AMR) and acute severe aortic regurgitation (AAR), represents a myriad of health concerns that contribute substantially to morbidity and mortality [2,4,[7][8][9][10][11][12]. Subsequently, their clinical significance necessitates swift diagnosis and the adoption of comprehensive management strategies.…”

Section: Introductionmentioning

confidence: 99%

“…echocardiographic findings in acute mitral and aortic regurgitation[1,7,8,27,40,41]. Left Atrium Variable.…”

mentioning

confidence: 99%

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Establishing a Novel Diagnostic Framework Using Handheld Point-of-Care Focused-Echocardiography (HoPE) for Acute Left-Sided Cardiac Valve Emergencies: A Bayesian Approach for Emergency Physicians in Resource-Limited Settings

Ekambaram

Hassan²

2023

Diagnostics

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Acute severe cardiac valve emergencies, such as acute severe mitral regurgitation (AMR) and acute severe aortic regurgitation (AAR), present significant challenges in terms of diagnosis and management. Handheld point-of-care ultrasound devices have emerged as potentially pivotal tools in ensuring the prompt and accurate diagnosis of these left-sided valve emergencies by emergency physicians, particularly in resource-limited settings. Despite the increased utilisation of point-of-care ultrasound by emergency physicians for the management of patients in states of acute cardiorespiratory failure, current diagnostic protocols cannot perform sufficient quantitative assessments of the left-sided cardiac valves. This review elucidates and evaluates the diagnostic utility of handheld point-of-care focused-echocardiography (HoPE) in native AMR and AAR by reviewing the relevant literature and the use of clinical case examples from the Emergency Department at Port Shepstone Regional Hospital (PSRH-ED)—a rural, resource-limited hospital located in KwaZulu-Natal, South Africa. Combining the findings of the review and clinical case illustrations, this review proceeds to synthesise a novel, Bayesian-inspired, iterative diagnostic framework that integrates HoPE into the evaluation of patients with acute cardiorespiratory failure and suspected severe left-sided valve lesions.

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Section: Acute Severe Left-sided Valve Incompetencementioning

confidence: 99%

Section: Acute Severe Left-sided Valve Incompetencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…echocardiographic findings in acute mitral and aortic regurgitation[1,7,8,27,40,41]. Left Atrium Variable.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Establishing a Novel Diagnostic Framework Using Handheld Point-of-Care Focused-Echocardiography (HoPE) for Acute Left-Sided Cardiac Valve Emergencies: A Bayesian Approach for Emergency Physicians in Resource-Limited Settings

Ekambaram

Hassan²

2023

Diagnostics

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“…Our Education in Heart article8 provides an overview of the clinical presentation, diagnostic approach and management of acute aortic valve regurgitation. Patient with acute aortic regurgitation typically present with pulmonary oedema or cardiogenic shock and the possibility of valvular heart disease often is not considered.…”

mentioning

confidence: 99%