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Rheumatic aortic regurgitation, due to rheumatic fibrosis, is often associated with stenosis in addition to incompetence. There is a slow progression and there is almost invariably coincidental with mitral valve disease.
Congenital regurgitation is usually identified by the loud ejection sound of the associated bicuspid valve or pansystolic murmur of the ventricular septal defect. There may be dilation of the ascending aorta.
Infective endocarditis may result in regurgitation and left ventricular failure. There may be other signs of endocarditis.
Isolated aortic root dilatation progresses more rapidly than rheumatic valvulitis. It is diagnosed on echocardiography.
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