Case 4 – A 67 Year-Old Man with Aortic Regurgitation Who Presented Syncope Followed by Shock

Clinical aspects

Patient with aortic insufficiency diagnosed at 57 years of age, presenting with several transient ischemic attacks simultaneous to atrial fibrillation. Presented with upper digestive bleeding and, finally, syncope followed by decreased consciousness and complex mixed shock with acute renal failure.

The patient showed normal aortic insufficiency clinical evolution, that is, progressive dilatation of the left ventricle with few cardiovascular symptoms. Generally, aortic insufficiency progression is slow and the left ventricle has time to dilate and handle high regurgitating volumes with normal filling pressure. This good compliance maintenance and low end-diastolic pressure has little repercussion on the left atrium and on the pulmonary venocapillary territory, thus there is no increase in liquid content in the lungs and dyspnea appears as a late symptom.

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