How will you differentiate between aortic regurgitation due to syphilis and rheumatic fever?
The pathology of AR
in syphilis and rheumatic fever are different. In syphilis there is aortic root
dilatation and in rheumatic fever there is valve damage.
Features of Rheumatic AR
1. Usually
affect young individuals
2. Past
history of rheumatic fever may be present
3. Other
valves may be affected
4. Usually
there is no diastolic thrill
5. A2
diminished
6. Murmur
is of blowing character
7. It
is best heard on 3rd left intercostals space
8. Peripheral
signs of AR are present.
Features of syphilitic AR
1. Older
individuals are affected
2. History
of exposure to syphilis present
3. Syphilitic
AR is usually an isolated lesion
4. Diastolic
thrill is more common than rheumatic AR
5. A2
is usually loud tambour like
6. Murmur
is ringing, cooing, or musical in nature
7. Best
heard along the right sternal border.
8. Peripheral
sign are more marked than rheumatic AR.
