The Clinical, ECG and CXR Findings of AR

The clinical, ECG and CXR findings in acute and chronic AR are shown in Table 1:

Table 1: Clinical, ECG and CXR findings of aortic regurgitation

Clinical, ECG and CXR findings of aortic regurgitation


Chronic AR

Acute AR

Rapid rise and quick collapse (water hammer pulse), double impulse, wide pulse pressure

  • Corrigan’s sign – visible carotid pulsation
  • Traube’s sign – ‘pistol shot’ sound heard over the femoral artery
  • Quincke’s pulse – capillary pulsation visible on shining a light through the fingertips
Tachycardia rapid rate of rise of arterial pulse
Cardiac impulse Hyperdynamic, maybe visible Normal or hyperkinetic

Soft blowing diastolic murmur LSE. Best heard with the patient sitting forward in fully held expiration

Duration of the murmur in diastole correlates with severity of AR

  • Austin Flint murmur – apical diastolic murmur caused by obstruction of mitral flow produced by the partial closure of the Mitral Valve by the regurgitant jet and rapid rising LV diastolic pressure
Early blowing diastolic murmur
ECG In moderate/severe disease – LVH with or without strain pattern Non specific ST – T changes and sinus tachycardia or may be normal or show changes consistent with the underlying cause
CXR Cardiomegaly with LV prominence and possibly dilated aorta ‘Normal’ heart size and pulmonary oedema