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
Feature	Chronic AR	Acute AR
Pulse	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
Auscultation	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