Atherosclerosis masks Hill's sign in severe chronic aortic regurgitation

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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.

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