1. What is responsible for the myriad of physical examination findings in patients with severe aortic regurgitation including pulsation of multiple organs?

A. Arrhythmia

B. Increased stroke volume

C. Congestive heart failure

D. Backward regurgitant flow

The peripheral signs of aortic regurgitation are mostly due to the high flow state, large stroke volume and wide pulse pressure seen in aortic regurgitation. In the 19th century in Europe, the infection syphilis (treponema pallidum) was widespread. Syphilitic aortitis was quite common resulting in aortic root dilation and severe aortic valve regurgitation. No good therapy including medical or surgical existed at that time so the disease was allowed to progress and many individuals developed severe congestive heart failure from the aortic valve regurgitation. This resulted in multiple descriptions of physical examination findings by different physicians attempting to diagnose aortic regurgitation as the cause of an individual’s congestive heart failure.