What is the pathophysiology of acute aortic regurgitation (AR)?

Updated: Nov 19, 2018
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Acute AR of significant severity leads to increased blood volume in the LV during diastole. The LV does not have sufficient time to dilate in response to the sudden increase in volume. As a result, LV end-diastolic pressure increases rapidly, causing an increase in pulmonary venous pressure and altering coronary flow dynamics. As pressure increases throughout the pulmonary circuit, the patient develops dyspnea and pulmonary edema. In severe cases, heart failure may develop and potentially deteriorate to cardiogenic shock. Decreased myocardial perfusion may lead to myocardial ischemia.

Early surgical intervention should be considered (particularly if AR is due to aortic dissection, in which case surgery should be performed immediately).

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