Atherosclerosis masks Hill's sign in severe chronic aortic regurgitation

Abstract

Increased systolic blood pressure gradient (SBPG) between the lower and upper extremities is a sign of severe chronic aortic regurgitation (AR). Among 23 patients (58±19 years) with severe AR≥3 months, we prospectively found the SBPG (BP difference between the lower and ipsilateral upper extremities) to be inversely related to maximal aortic intimal-medial thickness measured on transesophageal echocardiography and to coronary disease. In severe chronic AR, SBPG is decreased in the presence of coronary artery disease (CAD) and more marked aortic atherosclerosis.