무심잡음성 대동맥판폐쇄부전증(silent Aortic Regurgitation)의 병발여부는 흉통, 말초맥박 및 심첨부박동, 맥압확장, 흉부 X-선 및 심전도상의 좌심실비대 소견등으로 추측할 수도 있겠으나 대동맥조영술에 의해서만 확진이 가능하였다.
[영문]
Aortic regurgitation is a commom valvular heart disease, usually the result of rheumatic fever, or syphilis, and rarely of congenital origin. It is frequently associated with other valvular heart diseases, especially mitral valve disease. It can be diagnosed by the presence of pulse pressure widening, a Corrigan pulse, and an early decrescendo diastolic murmur at the left sternal border between the second and third intercostal spaces. After the clinical application of cineaortography in the diagnosis of valvular heart disease, Segal et al(1964) first reported rheumatic aortic regurgitation without an audible murmur in patients having mitral valve disease. The importance of discovering aortic regurgitation in patients with predominant mitral disease has begun to be appreciated recently, especially as commissurotomies for the relief of mitral stenosis are performed more frequently. Nowadys even though the severity of aortic regurgitation is often not evident preoperatively, aortic regurgitation can become very evident when mitral stenosis is relieved.
This study was comprised of seventeen patients with silent aortic regurgitation which was confirmed by cineaortgraphy at Severance Hospital from January, 1970 to August, 1976.
1. Of the seventeen patients, 12 patients were associated with mitral stenosis, 4 with mitral steno-insufficiency, and 1 with mitral insufficiency.
2. Silent aortic regurgitation was suggested from the accompanying clinical features such as chest pain, apical pulse bounding, pulse pressure widening, and a left ventricular hypertrophy pattern on both roentgenogram of the chest and electrocardiogram.
3. The severity of the aortic regurgitation was mild to moderate; 7 of the 17 patients being grade Ⅰ and 10 patients being grade Ⅱ with no grade Ⅲ and Ⅳ regurgitation noted on cineaortogram.