Aortic regurgitation: ventricular adaptation and failure
THE CONTEXT
Regurgitant blood increases the volume the left ventricle must handle, producing compensatory changes followed by ventricular failure as disease progresses.
Compensatory changes
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Regurgitation through the aortic valve causes left ventricular dilatation. Cardiac output increases to meet both circulatory demands and the regurgitant volume.
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Left ventricular stroke volume may eventually double, making the major arteries conspicuously pulsatile.
Progression to failure
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Progressive disease causes left ventricular failure, with a rise in left ventricular end-diastolic pressure and pulmonary oedema.