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September 1965

The Clinical Evaluation of Aortic Regurgitation: With Special Reference to a Neglected Sign: the Popliteal-Brachial Pressure Gradient

Author Affiliations


From the Division of Cardiovascular Diseases, Department of Medicine, New Jersey College of Medicine, and the Thomas J. White Cardiopulmonary Institute, B.S. Pollak Hospital for Chest Diseases. Assistant Professor of Medicine (Dr. Frank); Instructor in Medicine (Dr. Casanegra); Formerly Research Fellow in Medicine (Dr. Migliori); Associate Professor of Medicine, New Jersey College of Medicine, Associate Director, Thomas J. White Cardiopulmonary Institute, and Established Investigator of the Union County Heart Association (Dr. Levinson).

Arch Intern Med. 1965;116(3):357-365. doi:10.1001/archinte.1965.03870030037008

AORTIC INSUFFICIENCY was first clearly described by Cowper in 1705 and the associated collapsing pulse by Vieussens in 1715.1 After Corrigan's classical clinicopathological correlation was presented in 1823,1 interest was primarily directed toward differentiating the various causes of the valve damage. With the advent of modern sphygmomanometry in 1896, attention was turned again to the physical findings in this disease and it was recognized that characteristic features are low diastolic pressure, increased systolic pressure, and wide pulse pressure. In addition, in 1909 Hill and associates 2,3 reported finding a consistently higher systolic pressure in the leg than in the arm in patients with aortic regurgitation, but not in normal subjects. Since that time, little has been added to the evaluation of this lesion, except for the description of various radiologic and electrocardiographic criteria of left ventricular enlargement and hypertrophy, which are pathologic concomitants of the disease.

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