[Echocardiography as a method for the determination of the severity of aortic insufficiency]

4 groups of patients with different degrees of aortic regurgitation (mild n = 7, moderate n = 3, severe n = 21, and aortic regurgitation combined with organic mitral stenosis n = 5) were examined by means of echocardiography and compared with a control group of 10 healthy subjects. The purpose was to determine what information echocardiography may provide in regard to the severity of aortic regurgitation and whether patients with organic mitral stenosis can be distinguished from patients with Austin Flint murmur. Patients with mild or moderate aortic regurgitation could not be clearly distinguished by echocardiographic features from subjects with normal cardiac findings. However, patients with severe aortic regurgitation were likely to show the following characteristic changes: (1) early mitral valve closure, (2) diastolic flutter, (3) absence of the a-wave. If a premature mitral valve closure, i.e. a negative QC time or a diastolic flutter or absent a-wave are found, the aortic regurgitation is likely to be of severe degree. This finding will be particularly useful in patients with acute aortic regurgitation, no left ventricular enlargement and no left ventricular hypertrophy in the ECG. Being a noninvasive method, echocardiography may also be used in follow-up examinations. Furthermore, organic mitral stenosis can be distinguished from Austin Flint murmur.