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Aortic Regurgitation I: Introduction

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...

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Updated: Feb 11, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

Aortic dissection presenting with acute pulmonary edema.

Wan-Ching Lien¹, Chih-Hung Wang¹, Wei-Tien Chang²

¹Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.

The American Journal of Emergency Medicine

|May 1, 2018

Summary

Acute aortic dissection can present as acute pulmonary edema due to severe aortic regurgitation (AR). A new murmur indicating AR may be the key to diagnosing this life-threatening condition.

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Area of Science:

Cardiology
Thoracic Surgery
Diagnostic Imaging

Background:

Acute aortic dissection is a life-threatening cardiovascular emergency requiring rapid diagnosis and intervention.
While traditional signs exist, severe aortic regurgitation (AR) can be the sole presenting symptom.
AR in dissection often stems from aortic root dilation or intimal flap interference with valve function.

Observation:

A 36-year-old male presented with acute, severe dyspnea.
Physical exam revealed a significant diastolic murmur, indicative of severe AR.
Bedside echocardiography showed a dissecting intimal flap obstructing aortic valve closure.

Findings:

The patient had a Stanford type A aortic dissection.
Echocardiography confirmed severe AR caused by a prolapsed dissecting intima flap.
Computed tomography revealed the dissection, with the aortic root obscured on chest X-ray.

Implications:

Acute pulmonary edema can be a specific presentation of aortic dissection.
New-onset AR murmurs are critical diagnostic clues for aortic dissection.
Prompt diagnosis via echocardiography and CT enables timely surgical intervention, improving outcomes.