There are many possible causes of AR, including:
- Degenerative valve disease
- Aortic root dilation (e.g. in connective tissue disorders like Marfan syndrome)
- Rheumatic heart disease
Acute causes (more sudden onset) include:
- Aortic dissection
- Infective endocarditis
- Iatrogenic causes (e.g. after valvular procedures)
- On physical exam, AR presents as a blowing, decrescendo diastolic murmur, best heard at the left sternal border. There may be signs of wide pulse pressure, such as bounding pulses or head bobbing (De Musset's sign).
- On POCUS, use colour doppler in the A5C view to look for a jet of blood flowing backward into the LV during diastole.