What are the major physical findings?

Physical findings in aortic regurgitation vary with the severity of disease. The murmur is diastolic, decrescendo, and heard along the left sternal border. It is frequently missed because it is very similar to normal breath sounds. Listening during held expiration improves chances of correctly identifying the murmur.

A third heart sound is common. An Austin-FIint murmur may be present. This murmur sounds exactly like that of mitral stenosis. Its pathogenesis is incompletely understood but results from interaction between the regurgitant jet and mitral valve inflow.

Significant aortic regurgitation is usually accompanied by a wide pulse pressure. This pulse pressure is typically at least 60 mmHg, and the diastolic pressure is typically 70 mmHg.

What are the peripheral pulse findings?

The wide pulse pressure can produce many abnormalities in the peripheral pulses:

Bifid carotid pulse

Visible carotid pulsations (Corrigan’s pulse)

Head bobbing (de Musset’s sign)

Bobbing of the uvula (Muller’s sign)

Femoral artery bruit induced by light pressure over the artery (Duroziez’s murmur)

Pistol shot sound over the femoral artery (Traube’s sound)

Visible pulsations in the nail beds (Quincke’s pulses).

What are the major physical findings? Photo Gallery

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