This case highlights that recurrent nontraumatic aortic tears, potentially exacerbated by steroid therapy and violent coughing, can lead to valvular avulsion and aortic insufficiency.
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Consider nontraumatic causes in unexplained AI; leaves open whether steroids and coughing contribute.
A case of aortic insufficiency due to avulsion of two of three semilunar valves was remarkable because of the intimal and medial tears which caused it. The tears were in different stages of repair, suggesting repetitive injury. Antemortem steroid therapy and bouts of violent coughing may explain these unusual findings.
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Jaworsky et al. (1985) studied this question.
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