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Severe aortic regurgitation → look for bounding pulses, wide pulse pressure, diastolic murmur at L sternal border

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Severe aortic regurgitation with symptoms – aortic valve repair (regardless of LVEF)

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Severe aortic regurgitation without symptoms + LVEF <55% → aortic valve repair

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Severe aortic regurgitation without symptoms + LVEF >55% + severely enlarged left ventricle (>50 mm at end of systole)→ aortic valve repair

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Severe aortic regurgitation without symptoms + LVEF >55% + unenlarged left ventricle→ 6-12 month follow-up with transthoracic echocardiography

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Transcatheter aortic valve implantation for severe aortic stenosis may have higher risks than surgical replacement; use only if patient is not a surgical candidate

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