Q. Pathology of aortic regurgitation?

In Post Inflammatory situations scarring and retraction of valve cusps lead to aortic regurgitation. Varying degrees of commissural fusion leads to incomplete opening and closing in rheumatic heart disease.

15 - 20 per cent of bicuspid valve patients will have significant aortic regurgitation. In Marfan's Syndrome due to abnormalities in fibrillin and in cystic medial necrosis due to abnormalities in elastin aortic wall becomes weak, stretched out and does not support commissures leading to incomplete central closure. In inflammatory aortitis situations like syphilis and ankylosing spondylitis, medial inflammation and scarring cause root dilatation. In SLE with anti cardiolipin antibodies, Libman-Sacks endocarditis and in rheumatoid arthritis, rheumatoid nodules cause scarring of valve cusps.