"4% per year of asymptomatic patients will develop symptoms or failure.
Prevalence: 13% of persons age 75-86 have moderate to severe AR.
Replacement if EF 20-50%
NYHA III-IV
concomitant IHD
aortic root dilatation > 50 mm
Aetiology:
Valvular disease = 40%
- congenital
- endocarditis
Nonvalvular disease = 60 %
- idiopathic 90%
- Marfans 10%
- systemic hypertension in 90% - suggests that altered elasticity of aortic root may have been cause of valve incompetence.
In the developing world