Acute native aortic regurgitation: clinical presentation, diagnosis and management

© Author(s) (or their employer(s)) 2022. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Acute native valve aortic regurgitation (AR) is a rapidly fatal condition resulting from the sudden loss of valve competency. Acute AR requires prompt intervention yet often is missed because the clinical presentation is not recognised. The large volume of retrograde diastolic flow into a left ventricle (LV) without compensatory dilation results in an abrupt decrease in cardiac output and increase in LV enddiastolic pressure (figure 1). Urgent surgical intervention to restore valve competency and treat the underlying cause is essential. Options for medical stabilisation or palliative care are limited. This review covers the aetiology, haemodynamics, clinical presentation, diagnosis, medical stabilisation and surgical management of patients with acute native valve AR.