Graphic findings in acute aortic regurgitation caused by destruction of aortic cusp. The origin of first heart sound.

The diagnosis of ruptured aortic cusp leading to acute aortic insufficiency was made by echophonocardiographic techniques in a patient with nonvegetative aortic valvular endocarditis and a negative clinical history. Early closure of the mitral valve, weak first heart sound, tall A wave of apexcardiogram, and early diastolic murmur indicated acute aortic regurgitation. Fine high frequency echoes of the aortic root and aortic leaflets suggested ruptured aortic leafet unlike that reported in the presence of vegetations. Timing of S1 in acute aortic regurgitation by phonocardiogram, echocardiogram, and pulse techniques could not establish a single causative valvular relation in the genesis of this sound.