Patient handout

Chronic aortic regurgitation

PRODUCTION

1. Your condition

This handout is for chronic aortic regurgitation. Your care team identified this based on: early diastolic decrescendo murmur at lsb.

Other reasons your team may use this plan: wide pulse pressure / bounding pulses; echo: severe ar (vc >0.6 cm, rf ≥50%, eroa ≥0.30 cm², holodiastolic flow reversal); bicuspid aortic valve / aortic root or ascending dilatation.

3. When to call your provider

Contact your care team if any of the following happen:

Symptoms OR heart pumping strength (LVEF) ≤55% OR LVESD >50 mm (>25 mm/m²) → surgical referral now — 2020 ACC/AHA VHD
Aortic root/ascending at threshold → aortic surgery — 2022 ACC/AHA Aortic
Acute severe AR (dissection/IE features) → ED + emergency route — 2020 ACC/AHA VHD

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Symptomatic severe chronic AR (stage D) — Class I surgical AVR — 2020 ACC/AHA VHD
Asymptomatic severe AR + heart pumping strength (LVEF) ≤55% (stage C2) — Class I AVR — 2020 ACC/AHA VHD
Marfan / Loeys-Dietz / vascular EDS — ARB + BB, earlier aortic surgery (Marfan ≥4.5–5.0 cm; Loeys-Dietz lower), genetics + cascade — 2022 ACC/AHA Aortic
Acute severe AR (endocarditis leaflet destruction or aortic dissection) — small non-compliant LV → shock/flash edema — EMERGENCY surgery — 2020 ACC/AHA VHD(life-threatening)
Pregnancy/planning — STOP ACEi/ARB; use BB; mWHO risk by aortic root size (root >4.5 cm Marfan = very high risk / consider pre-pregnancy repair); cardio-obstetric — ESC 2018 Pregnancy

5. Follow-up

Family screening (bicuspid/syndromic); route to HFrEF engine if LV dysfunction

6. Sources

Guideline: 2020 ACC/AHA VHD Guideline + 2022 ACC/AHA Aortic Disease Guideline + 2021 ESC/EACTS VHD Guideline