Page Contents
OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is aortic regurgitation (aortic valve insufficiency). While this may seem a odd practice, it is useful to see multiple examples of how aortic regurgitation will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for aortic regurgitation.
- Exertional dyspnea can be a presenting complaint of patients:
- Heart murmur typical heard at the left sternal border
- Early diastolic murmur: decrescendo murmur that begins after S2
- High pitch/blowing murmur
- Widened pulse pressures: a large gap between systolic and diastolic blood pressures is not uncommon.
- Bounding pulses/waterhammer pulse can be noted when measuring peripheral pulses
- Signs of left heart failure can be apparent after longer periods of time.
QUESTION EXAMPLES
Question # 1
A 35 year old male come stoeckled the clinic because of mild exertion dyspnea and a pounding heart for the past 4 months. He explains that he is uncomfortably aware of his heart beat while he is lying down to rest on his left side. His vital signs are: blood pressure of 155/45 mm Hg, and a pulse of 75/min. What could be the cause of this patient’s symptoms?
Explanation # 1
Exertional dyspnea + pounding heart sensation + widened pulse pressure = aortic regurgitation
Question # 2
An asymptomatic 45 year old female comes to the clinic for a routine exam. She has no past medical history of rheumatic fever, and she does not take any medications. Her pulse is 75 ppm, and her blood pressure is 150/55 mm Hg. A grade 2/6 decrescendo murmur after S2 is heard at the left sternal border. What might be the cause of this patient’s murmur?
Explanation #2
Widened pulse pressures + decrescendo diastolic murmur + heard at left sternal border = aortic regurgitation
Question # 3
Explanation #3
Question # 4
Explanation #4
TESTABLE FACTS ABOUT THIS CONDITION (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable facts regarding some aspect of the disease’s pathophysiology/management/clincial implications that are commonly asked. Some of these are listed below:
- What causes it: aortic root dilation, bicuspid aortic valve, endocarditis, rheumatic fever, ascending aortic aneurysm
Page Updated: 04.01.2017