Aortic insufficency with murmur dangerous?

[jackadams]

Hi, I am 25 years old and a male. To make a long story short I thought I was having a aortic dissection based on the symptoms I read online. I went to the ER and the doctor also thought the same thing. I am also concerned about having Marfans ( they say I dont) since I have alot of the symptoms so he checked for aortic dissection with a EKG, Chest X Ray and CT scan.

He said my aorta looked fine and I was not having a dissection. I recently had a friend who works in the medical feild take a look at my CT scan for a measurement of my aorta and she said the size looked fine and everything looked normal.

But heres the thing, before the doc did the CT scan he said he heard aortic insuffiency associated with a mumur that signaled dissection to him. He was deadset that I was having a dissection and took action quickly. But that turned out fine.

However with the stephoscope he said he heard aortic insuffeincy. I have what they call white coat syndrome, a bad case of it! I get more nervous at the docs office than I do doing a public speech. My Blood pressure when I got there was 220/110! They laid me in a bed and strapped me to a BP monitor and within about 7 minutes after the doctor left it went down to 155/82 which is still high.

But in all honesty I was waiting for the results of my CT scan and I was still very nervous. My Bp at home is even lower then this but here are my questions:

1. If he heard aortic insuffeincy with the stephoscope and a murmor associated with it does this mean its severe or can the degree only be told with an echocardiogram?

2. If my blood pressure was that high when I was nervous would it make the aortic insuffiency easier to hear since my hearts beating faster and everything?

I will also say that my resting pulse in the ER was 150 when the doctor was around but when he left it went down to 95. But at home its constantly at 60-75 beats per minute.

[littledove54]

A related discussion, aortic insufficiency was started.

[jackadams]

Thanks so much for the answer. So basically it can be hard to determine with the stephoscope alone if I have aortic insuffeincy or not right?

But you say the cardiologist should be able to tell with the stephoscope if I have AI and how severe it is just by the sound? How accurate can that be? Are we talking 50% accuracy or what? Or is a echocardiogram really needed to see how severe it is. Because if you can hear the AI can it still be trace to mild amounts?

Thanks again!

[Cleveland Clinic]

Murmurs are often difficult to distinguish, especially by non-cardiologists.  The ER doc may have heard a flow murmur because of white coat syndrome and tachycardia.  That's a benign finding.  Since there is no dissection and the aorta looked normal the likelihood of any pathology in the aortic valve is very low.  An echo would be the most definitive test to look for any AI.  Of course, I think you should see a cardiologist, who by listening alone should be able to tell whether or not there is any AI.  As far as the severity goes, again, a cardiologist will be able to tell the severity of AI based on the exam alone.  The echo also helps.  The relationship between AI and HTN and tachycardia is somewhat complex and unpredictable, and I don't think that at a HR of 150 beats per minute anyone would be able to appreciate AI at all, let alone be able to judge its severity.  I would therefore not be very concerned about what was told in the ER.  If you are very concerned and knowing for sure will put you at ease I would recommend seeing a cardiologist.