Saturday, August 5, 2017

Hill’s criteria in Aortic Regurgitation

Hey Awesomites

Normally, the lower limbs systolic blood pressure ( measured on popliteal artery by indirect method, using sphygmomanometer ) is 10-20 mmHg higher than that of upper limbs ( brachial artery ).
This is because:
1. The lower limb vessels are more muscular than the upper limb vessels.
2. Lower limb vessels are in direct continuation of the Aorta, whereas the upper limb vessels form an angle of 90°.
3. The increased blood pressure is the result of summation effects of reflected pressure waves.
As a result, the pressure waves are transmitted at a higher speed in the wall of lower limb vessels which then get reflected at the end to increase further with the incoming wave.

In Aortic Regurgitation, the greater amplitude of pressure waves results in exaggerated increase in systolic blood pressure of lower limbs vessels compared to that of upper limbs.

The grading of severity of aortic regurgitation based on Hill’s criteria is as follows :
Mild - difference of 20-40 mmHg
Moderate - difference of 40-60 mmHg
Severe - difference of >60 mmHg.

Thats all
Hope that helped :)
- Jaskunwar Singh


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