Aortic regurg. Most common symptom, progressive
dysnea on exertion, that is pretty nonspecific.
Physical examination. What are you going to
find? Early diastolic murmur right after S2,
not mid-diastolic murmur and you sure as
heck not going to hear what? An opening snap.
Next, remember. Now that you have increased
amounts of blood in your left ventricle and so
therefore, you are going to have an increase
in left ventricular size and hypertrophy. That
is called eccentric. Typically heard over
where? Right second intercostal space. Aortic
regurg, right normally you should hear there
but if you have pathology it will then go
towards the apex on your left side.
What does this Austin Flint mean to you? Not good.
This means that for the most part that the aortic
regurg is so bad in which not only
blood coming in from your aorta into left
ventricle, but you also have blood coming
in from left atrium during diastole, don’t
you? When you have two huge bodies of fluids
hitting against each, you are going to
create another murmur and so this is then
referred to as being Austin Flint. First,
make sure you are solid with the understanding
of aortic regurg with everything we have discussed
and if you want to go further there is something
called Austin Flint with aortic regurg which
is not a good indicator. Bad prognosis. That's because
all the blood is then causing more turbulent
flow. Pulmonary rales, Sure, at some
point in time
everything will back up into your left atrium, pulmonary
veins, you might have issues.
What is going to happen in the next couple
of slides ,the theme is increased blood flow
to different parts of the body in which you
have bounding pulses.
The names here, if you want to remember them
so be it, but it is more important that you
understand the concept. What is Corrigan’s
sign? It is forceful distension of arterial
pulse with a quick collapse. What happens to
pulse pressure? Increased. What happens to
diastolic blood pressure? Decreased.
Quincke's. Once again capillary pulsation seen
on light compression on nail bed. Light, not hard. If you do
it hard, sure it disappears. But even on light, it disappears.
Muller's. Pulses of your uvula. You see this
everywhere. Tell me about your pulses. It
is increased. You want to know the names?
Here they are. Muller's, De-Musset's, Durozier's sign. Bruit.