Case 1

What is the lesion and grade?

Aortic Regurgitation

• 1+ Small amount of contrast in the left ventricle during diastole that clears with each beat and never completely fills the left-ventricular chamber
• 2+ Faint opacification of the entire left ventricle
• 3+ Dense opacification of the left ventricle (as dense as the aorta)
• 4+ Complete and dense opacification of the left ventricle during the first cardiac cycle and the left ventricle is more densely opacified than the aorta

Acute AR

• Severe volume load on LV
• Dramatic rise in LVDP which nears aortic diastolic pressure
• Premature closure of mitral valve

Chronic AR

• If compensated often normal hemodynamics
• Widened pulse pressure
• AS symptoms develop the LVEDP goes up

Severe AR?

• CO 2.5 L/min
• HR 100 BPM
• Angiographic LVEDV 100mL
• Angiographic LVESV 50mL