A 30-year-old man with chronic aortic regurgitation has BP 170/50 mmHg. The widened pulse pressure results primarily from:
- A High stroke volume ejected into a compliant aorta raising systolic pressure, plus runoff into the left ventricle lowering diastolic pressure ✓
- B Elevated diastolic pressure due to increased peripheral resistance
- C Stiffening of the aorta restricting its ability to store elastic energy
- D Reduced total peripheral resistance alone without any change in stroke volume
Correct answer: A. High stroke volume ejected into a compliant aorta raising systolic pressure, plus runoff into the left ventricle lowering diastolic pressure
Explanation
Regurgitant plus forward flow enlarges total left ventricular stroke volume, elevating systolic pressure, while diastole sees blood escaping both peripherally and backward into the ventricle, dropping diastolic pressure. Peripheral resistance actually falls in chronic regurgitation, ruling out option B. Bounding signs such as Corrigan pulse and water-hammer pulse follow from this same widened pulse pressure physiology.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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