From the Research
Muller's sign is a clinical indicator of aortic regurgitation, characterized by a pulsating uvula, and its presence is associated with severe aortic regurgitation, as evidenced by recent studies 1. Muller's sign is a physical examination finding that can be observed in patients with aortic regurgitation, which is a valvular disease characterized by retrograde blood flow from the aorta to the left ventricle. This sign is caused by the transmission of the aortic regurgitant wave to the uvula, resulting in its pulsation. The presence of Muller's sign is often associated with severe aortic regurgitation, which can have significant implications for patient management and outcomes.
Key Points to Consider
- Aortic regurgitation is a common form of valvular disease, and its severity can be assessed using echocardiography 2, 3, 1.
- The diagnosis and management of aortic regurgitation require a comprehensive approach, including routine clinical and echocardiographic follow-up 2, 4.
- Severe aortic regurgitation has a major impact on the myocardium and carries a significant risk of morbidity and mortality if left untreated 3, 4.
- Established and novel echocardiographic methods, such as global longitudinal strain and three-dimensional echocardiography, allow an estimation of this risk and provide invaluable information for patient management and prognosis 3, 1.
- The presence of Muller's sign may help guide diagnosis and prompt further evaluation, including echocardiography and other cardiac imaging modalities 1.
Management and Treatment
- Medical management of chronic aortic regurgitation aims to control hypertension and delay left ventricular dysfunction, using medications such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and potentially calcium-channel blockers 4, 5.
- Surgical or percutaneous therapy is indicated when symptoms develop and in those who have left ventricular dysfunction or left ventricular dilation 2, 4.
- The use of transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgery in patients at high operative risk 2.