Aortic regurgitation echocardiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

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Overview

The most common test used for the evaluation of the severity of aortic insufficiency is the echocardiogram, which can provide two-dimensional views of the regurgitant jet, and allow measurement of the velocity and volume of the jet.

Echocardiographic Findings in Severe Aortic Insufficiency

The echocardiographic findings in severe aortic regurgitation include:

• An AI color jet dimension > 60 percent of the left ventricular outflow tract (LVOT) diameter (may not be true if the jet is eccentric)
• The pressure half-time of the regurgitant jet is < 250 msec
• Early termination of the mitral inflow (due to increase in LV pressure due to the AI.)
• Early diastolic flow reversal in the descending aorta.
• Regurgitant volume > 60 ml
• Regurgitant fraction > 55 percent

Aortic Regurgitation M Mode

• Increased duration between E and A peaks
• Fluttering of the anterior mitral valve leaflet due to AI jet turbulence
• Clinical setting to decide mechanism

Severe aortic insufficiency 1

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Severe aortic insufficiency 2

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Severe aortic insufficiency 3

Severe acute aortic insufficiency is considered a medical emergency. There is a high mortality rate if the individual does not undergo immediate surgery for aortic valve replacement. If the acute AI is due to aortic valve endocarditis, there is a risk that the new valve may become seeded with bacteria. However, this risk is small.

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