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Aortic insufficiency (regurgitation). A: Drawing of the left heart in left anterior oblique view showing anatomic features of aortic insufficiency. Note
structures enlarged: left ventricle, aorta. B: Drawing showing auscultatory and hemodynamic features of predominant aortic insufficiency. Cardinal features
include large hypertrophied left ventricle; large aorta; increased stroke volume; wide pulse pressure; diastolic murmur. (SM, systolic murmur; A, aortic
valve; P, pulmonary valve; DM, diastolic murmur.) (Redrawn, with permission, from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Originally published
by Appleton & Lange. Copyright © 1993 by The McGraw-Hill Companies, Inc.) C: Pressure-volume loop in chronic aortic insufficiency. Marked
enlargement in left ventricular volume shifts the diastolic pressure-volume curve rightward. Hypertrophy of the ventricle shifts the isovolumic pressureSource: Cardiovascular Disorders: Heart Disease, Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e
volume curve leftward (not shown), but ultimately the ventricle dilates and contractility decreases and the isovolemic pressure-volume curve shifts to the
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into the ventricle. Because the ventricle is constantly being filled from the mitral valve or the incompetent aortic valve, no isovolumic periods exist.
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