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Aortic regurgitation

最后审阅: 18 Aug 2025
最后更新: 12 Dec 2024

小结

定义

病史和体格检查

关键诊断因素

  • diastolic murmur
完整详情

其他诊断因素

  • dyspnea
  • fatigue
  • weakness
  • orthopnea
  • paroxysmal nocturnal dyspnea
  • pallor
  • mottled extremities
  • rapid and faint peripheral pulse
  • jugular venous distension
  • basal lung crepitations
  • altered mental status
  • urine output <30 mL/hour
  • soft S1
  • soft or absent A2
  • collapsing (water hammer or Corrigan) pulse
  • cyanosis
  • tachypnea
  • displaced, hyperdynamic apical impulse
  • chest pain
  • pink frothy sputum
  • wheeze (cardiac asthma)
  • additional heart sounds
  • arrhythmias
  • ejection systolic flow murmur
  • Austin Flint murmur
  • systolic thrill
  • Hill sign
  • Bisferiens pulse
  • de Musset sign
  • Muller sign
  • Traube sign
  • Quincke sign
  • Duroziez sign
  • Mayen sign
  • Lighthouse sign
  • Becker sign
  • Landolfi sign
  • Rosenbach sign
  • Gerhardt sign
  • Lincoln sign
  • Sherman sign
  • palmar click
  • syncope
完整详情

危险因素

  • bicuspid aortic valve
  • rheumatic fever
  • endocarditis
  • Marfan syndrome and related connective tissue disease
  • systemic hypertension
  • aortitis
  • older age
完整详情

诊断性检查

首要检查

  • ECG
  • chest x-ray
  • echocardiogram
  • M-mode and 2-dimensional imaging
  • color flow Doppler
  • pulsed wave Doppler
  • continuous wave Doppler
完整详情

需考虑的检查

  • radionuclide angiography
  • MRI
  • exercise stress testing
  • cardiac catheterization
完整详情

治疗流程

急症处理

acute AR

持续性治疗

chronic AR: mild to moderate

chronic AR: severe, asymptomatic

chronic AR: severe, symptomatic

撰稿人

作者

Poorna R. Karuparthi, MD, FACC

Associate Professor of Medicine

University of Missouri-Columbia

Chief of Cardiology

Harry S. Truman Veterans' Hospital

Columbia

MO

利益声明

PRK declares that he has no competing interests.

鸣谢

Dr Poorna R. Karuparthi would like to gratefully acknowledge Dr Sanjeev Wasson and Dr Nishant Kalra, previous contributors to this topic.

利益声明

SW and NK declare that they have no competing interests.

同行评议者

Kul Aggarwal, MD, MRCP, FACC, FACP

Professor of Clinical Medicine

University of Missouri-Columbia

Chief

Cardiology Section

Harry S. Truman Veterans Hospital

Columbia

MO

利益声明

KA declares that he has no competing interests.

Rajdeep Khattar, DM, FRCP, FACC, FESC

Consultant Cardiologist and Honorary Senior Clinical Lecturer

Manchester Heart Centre

Central Manchester and Manchester Children's NHS Foundation Trust

Manchester

UK

利益声明

RK declares that he has no competing interests.

John Pepper, MChir FRCS

Consultant Cardiac Surgeon

Department of Surgery

Royal Brompton Hospital

London

UK

利益声明

JP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Feb 2;77(4):e25-197.全文  摘要

Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2022 Feb 12;43(7):561-632.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • 指南

    • 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain
    • 2021 ESC/EACTS guidelines for the management of valvular heart disease
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