Chapter 9: Echocardiography in acute aortic insufficiency

Acute severe aortic insufficiency (AI) is an uncommon yet life-threatening condition that necessitates prompt recognition and management.
Acute AI can occur in a variety of clinical conditions affecting the aortic valve or the aortic root, including proximal aortic dissection (type I or type A), endocarditis of the aortic valve, trauma, or deterioration of an aortic prosthetic valve.
Echocardiography has become an indispensable tool to confirm the presence of aortic insufficiency, assess its severity, and define its etiology.
In acute AI, the left ventricle size may be normal with a hyperdynamic LVEF. A variety of two-dimensional and color and spectral Doppler echocardiographic assessments can help to determine the size and severity of the aortic regurgitant jet and demonstrate the acute diastolic volume load on the left ventricle.
Transthoracic and transesophageal echocardiography are crucial in the perioperative management of the patient with acute severe AI.

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