Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- sopro diastólico
Other diagnostic factors
- dispneia
- fadiga
- fraqueza
- ortopneia
- dispneia paroxística noturna
- palidez
- mosqueamento das extremidades
- pulso periférico rápido e fraco
- estase jugular
- crepitações nas bases pulmonares
- estado mental alterado
- débito urinário <30 mL/hora
- B1 hipofonética
- A2 hipofonética ou ausente
- pulso em colapso (em martelo d'água ou de Corrigan)
- cianose
- taquipneia
- impulso apical deslocado e hiperdinâmico
- dor torácica
- expectoração rósea e espumosa
- sibilo (asma cardíaca)
- sons cardíacos adicionais
- arritmias
- sopro do fluxo sistólico de ejeção
- sopro de Austin Flint
- frêmito sistólico
- sinal de Hill
- pulso bisferiens
- sinal de Musset
- sinal de Muller
- sinal de Traube
- sinal de Quincke
- sinal de Duroziez
- sinal de Mayen
- sinal de Lighthouse
- sinal de Becker
- sinal de Landolfi
- sinal de Rosenbach
- sinal de Gerhardt
- sinal de Lincoln
- sinal de Sherman
- estalido palmar
- síncope
Risk factors
- valva da aorta bicúspide
- febre reumática
- endocardite
- síndrome de Marfan e doenças relacionadas do tecido conjuntivo
- hipertensão sistêmica
- aortite
- idade avançada
Diagnostic investigations
1st investigations to order
- eletrocardiograma (ECG)
- radiografia torácica
- ecocardiograma
- modo-M e imagem bidimensional
- Dopplerfluxometria colorida
- Doppler de onda pulsada
- Doppler de onda contínua
Investigations to consider
- angiocintilografia
- RNM
- teste ergométrico
- cateterismo cardíaco
Treatment algorithm
regurgitação aórtica aguda
RA crônica: leve a moderada
RA crônica: grave, assintomática
RA crônica: grave, sintomática
Contributors
Authors
Poorna R. Karuparthi, MD, FACC
Associate Professor of Medicine
University of Missouri-Columbia
Chief of Cardiology
Harry S. Truman Veterans' Hospital
Columbia
MO
Disclosures
PRK declares that he has no competing interests.
Acknowledgements
Dr Poorna R. Karuparthi would like to gratefully acknowledge Dr Sanjeev Wasson and Dr Nishant Kalra, previous contributors to this topic.
Disclosures
SW and NK declare that they have no competing interests.
Peer reviewers
Kul Aggarwal, MD, MRCP, FACC, FACP
Professor of Clinical Medicine
University of Missouri-Columbia
Chief
Cardiology Section
Harry S. Truman Veterans Hospital
Columbia
MO
Disclosures
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
Disclosures
RK declares that he has no competing interests.
John Pepper, MChir FRCS
Consultant Cardiac Surgeon
Department of Surgery
Royal Brompton Hospital
London
UK
Disclosures
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.
References
Key articles
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.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Regurgitação mitral (RM)
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