Aortic Regurgitation: Severity Criteria and Learning Path

AR Severity Criteria: How to Read VC, EROA, Regurgitant Volume, and Regurgitant Fraction

Read AR severity by concordance across VC, EROA, regurgitant volume, regurgitant fraction, and diastolic flow reversal. PHT is context, not a primary severity signal.

LV Response in Chronic AR: When the Ventricle Changes the Decision Frame

Severity tells you the valve problem. LV response tells you whether the ventricle is still coping. In chronic AR, those are two separate questions — and the Intervention Navigator evaluates them in two separate steps.

Acute AR Red Flags: When Chronic LV Staging Does Not Apply

A normal LV in acute AR is not reassuring. It is unprepared. The Intervention Navigator handles this through a separate acute evaluation pathway, bypassing the chronic LV threshold logic entirely.

Why PHT Is Context in This Tool, Not a Severity Signal

A short PHT has become associated with severe AR in clinical practice, but the association is indirect. PHT is shaped by loading conditions, LV compliance, heart rate, and acute versus chronic physiology — and the AR Severity Tool accounts for this by treating PHT as context rather than signal.

Holodiastolic Flow Reversal in AR: What Each Site Means

Holodiastolic reversal in the descending aorta and holodiastolic reversal in the abdominal aorta are not the same finding in this tool — one is a counted severe echo sign, the other is supportive context. The distinction matters when interpreting the grade.

AR Before Noncardiac Surgery: Perioperative Risk Framing

Noncardiac surgery does not change whether AR is severe or how the LV is adapting. What it changes is the clinical conversation: knowing the AR context before surgery allows for hemodynamic planning, appropriate monitoring decisions, and clearer communication between the anesthesia and surgical teams.

Acute AR with Normal LV Dimensions: Why Normal Size Does Not Mean Tolerated

A patient with fever, hemodynamic instability, and a new aortic regurgitant murmur. Echo shows severe AR with normal LV size and preserved LVEF. This case illustrates why the acute AR red flag changes the clinical frame.

Severe AR, Preserved EF, but LVESD Is Above Threshold: How the Evaluation Frame Changes

An asymptomatic patient with confirmed severe AR. LVEF is 58% — above the 55% threshold. But LVESD is 53 mm, above the 50 mm threshold. The Severity Tool shows Stage C1. The Intervention Navigator shows a different path.

Non-Severe AR with a Short PHT: Why the Tool Grade Does Not Change

A patient with moderate-range AR quantitative parameters and a PHT of 340 ms. The PHT is short — a finding often associated with more significant AR — but the grade is non_severe_ar_pattern. This case shows why PHT is treated as context in this tool, not as a severity signal.

Severe AR Before Elective Noncardiac Surgery: Separating the Valve Decision from the Surgical Plan

A 67-year-old woman with confirmed severe AR and preserved LV function, scheduled for elective colectomy. The Severity Tool confirms severe_ar_pattern. The Navigator places her in the asymptomatic surveillance path with an NCS context flag. This case shows how the valve evaluation frame and the surgical planning frame are handled separately.

Non-Severe AR with Aortic Root Dilatation: Two Separate Concerns, One Echo

A 44-year-old man with a bicuspid aortic valve, non-severe AR by all quantitative parameters, and an aortic root of 50 mm. The AR grade is non_severe_ar_pattern. The Navigator adds an aortic root flag. This case illustrates how the tool separates the AR evaluation from the root context.