Which are the classic peripheral signs described in aortic insufficiency that can help in assessing the severity of this valvular heart condition?
- Duroziez’s Sign:
To and fro murmur when stethoscope is pressed over the femoral artery. - Hill’s Sign:
In severe aortic insufficiency, the popliteal pressure is >= 20 mmHg - Carotid shudder
- De Musset’s sign:
- Head bobbing sign, best seen in patients who are sitting or standing quietly.
- Alfred De Musset is one of the greatest French poets of the 19th century with presumably luetic aortic insufficiency.
- Corrigan’s pulse = Watson’s water hammer pulse:
- Peripheral manifestations of wide pulse pressure
- Also seen in PDA.
- Pulse pressure:
- Of little use in assessing the degree of aortic insufficiency in any patient
- Correlate little with prognosis
- Diastolic pressure of at least 70 mmHg and pulse pressure of less than 40 mmHg exclude moderate or severe AI but the contrary is not true.
- Rosenbah’s sign:
Hepatic pulsation, a late manifest ion of severe AI - Gehard’s sign:
Spleenic pulsation, detected only if the spleen is enlarged for another reason. - Becker’s sign:
Visible pulsations of the retinal arterioles - Mueller’s sign:
Pulsating uvula - “Piston shot” sounds:
- Heard in 45 % of very severe AI. Also seen in other high stroke volume
- e.g. anemia and hyperthyroidism
- Traube’s sounds:
Femoral double sound elude by compressing the femoral artery with a finger distal to the stethoscope head with just the correct amount of pressure. - Quincke’s sign (Of no diagnostic value):
- Quincke’s pulse seen by exerting on the edge of the nail, a pressure that is greater than the diastolic but less than the systolic.
- With each heart beat, a forward and backward movement of the margin between the red and the clear zone.
- Originally described by Quincke’s in himself and seen in normal persons usually.
- Mayne’s sign (Of no diagnostic value):
- Decrease in the indirect diastolic blood pressure of 15 mm Hg when the arm is held above the head as compared with the baseline diastolic blood pressure taken with the arm at the level of the heart.
- Occurs in 65% of normal persons.
