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Landolfi's Sign: A Riddle for Primary Care Physicians

Ritwik Ghosh1, Swagatam Sengupta2, Sk Minhajuddin Siraj3

  • 1Department of General Medicine, Burdwan Medical College, Burdwan, West Bengal, India.

Journal of Primary Care Specialties : Official Publication of the Institute of Family Medicine and Primary Care
|July 22, 2022
PubMed

Insights

Landolfi's sign, a pupil abnormality, indicates severe aortic regurgitation. This case highlights the importance of clinical examination and echocardiography in diagnosing heart conditions, especially in remote areas.

Area of Science:

  • Cardiology
  • Ophthalmology

Background:

  • Landolfi's sign, characterized by alternating pupillary constriction and dilatation, is a clinical sign associated with aortic regurgitation.
  • Aortic regurgitation is often linked to degenerative and rheumatic heart diseases, prevalent in rural India where patients may present late with complications.

Purpose of the Study:

  • To report a case of severe aortic regurgitation presenting with Landolfi's sign in a pregnant female.
  • To emphasize the significance of bedside clinical skills and diagnostic tools in primary healthcare settings.

Main Methods:

  • Clinical examination to identify Landolfi's sign.
  • Doppler echocardiography for diagnosis of severe aortic regurgitation.
  • Management with anti-failure medications and close feto-maternal monitoring.

Main Results:

  • A 34-year-old pregnant female presented with acute heart failure and Landolfi's sign.
  • Doppler echocardiography confirmed severe aortic regurgitation.
  • The patient was stabilized, and feto-maternal health was monitored.

Conclusions:

  • Bedside clinical training in cardiology is crucial, particularly in primary healthcare facilities with limited resources.
  • Basic diagnostic tools like echocardiography should be accessible in primary healthcare centers for timely diagnosis and management of critical conditions like aortic regurgitation.

Keywords:
Aortic regurgitationLandolfi’s sign

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