How to look for holodiastolic descending aortic flow reversal in severe aortic regurgitation?

That can be checked from the suprasternal view. First obtain a colour Doppler image of aortic arch and proximal descending aorta. Colour Doppler will show the reverse flow in diastole in severe aortic regurgitation. Place the Doppler line aligned to the center of aortic isthmus, just beyond the origin of left subclavian artery. Holodiastolic flow reversal in descending aorta with an end diastolic velocity above 20 cm/s is one of the features of severe aortic regurgitation. End diastolic velocity is measured at the peak of the R wave on simultaneous ECG. Velocity time integral of the diastolic flow more than 15 cm is also indicative of severe aortic regurgitation.

Image Attribution: Ramachandran Muthiah. Native Aortic Valve Endocarditis—A Case Report. Case Reports in Clinical Medicine. 7 (9), 2018. DOI: 10.4236/crcm.2018.79043 Creative Commons Attribution 4.0 International License.