A male patient, 55 years old, presented with dyspnea; he did an Echo study that showed moderate aortic incompetence! But if you look closely at the images, you will notice the eccentricity of the aortic jet, so it should be qualified as severe incompetence! Share your opinion in the comments!

Grading of the aortic incompetence severity

Grading of AR severity depend on four main items:

• Structural parameters
• Qualitative doppler parameters
• Semi-quantitative Doppler parameters
• Quantitative Echo-Doppler parameters
• Structural parameters:
  • AR evolves slowly but is usually accompanied by LV dilation and wide coaptation of the aortic valves of flail leaflet that can be seen with 2D echo
• Qualitative doppler parameters:
  • Jet width/LVOT diameterProximal flow convergenceDenisity of the CW jetJet deceleration rate
  • Holodiastolic flow reversal in the proximal descending aorta
• Semiqualitative parameters
  • Vena contract
  • Jet area/LVOT area
• Quantitative parameters
  • Flow conversion method (PISA)Regurgitation volume
  • EROA