Murmur of Aortic Dissection

Q:  Murmur of acute aortic dissection can be best heard at? (select one)

A) right sternal border 
B) left sternal border 


 Answer: A

The objective of the above question is to bring into light the 'location difference' of aortic regurgitation murmur secondary to aortic dissection and primary aortic valve disease. 

•  The murmur of aortic regurgitation due to the aortic dissection is best audible along the right sternal border 
• The murmur of aortic regurgitation due to the primary aortic valve disease is best audible along the left sternal border 

 Other clinical signs help to distinguish between the two clinical conditions, as the presentation of acute aortic dissection is relatively dramatic associated with acute sharp tearing chest pain often radiating to back, a wide pulse pressure, hypotension, possible pulse deficit, and neurological symptoms.

#cardiology
#surgicalcriticalcare


References: 

1. Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation 2003; 108:628. 

2. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 2000; 283:897.