Locomotor Brachii Sign in Aortic Regurgitation

This image-based case report presents a 60-year-old man with exertional dyspnea and a history of ischemic stroke, diagnosed with chronic severe aortic regurgitation. Notable clinical findings included wide pulse pressure (141/55 mm Hg), bounding carotid pulses, and the rare locomotor brachii sign tortuous, visibly pulsatile brachial arteries that expand in systole and collapse in diastole. Echocardiography revealed a bicuspid aortic valve with severe regurgitation, a moderately enlarged left ventricle, and mildly dilated aortic root. Doppler ultrasonography showed diastolic flow reversal in the brachial arteries. The patient was referred for surgical aortic-valve replacement. Locomotor brachii sign occurs in the setting of severe valvular insufficiency or arteriosclerosis and illustrates the peripheral consequences of aortic regurgitation.

This image-based case report presents a 60-year-old man with exertional dyspnea and a history of ischemic stroke, diagnosed with chronic severe aortic regurgitation. Notable clinical findings included wide pulse pressure (141/55 mm Hg), bounding carotid pulses, and the rare locomotor brachii sign tortuous, visibly pulsatile brachial arteries that expand in systole and collapse in diastole. Echocardiography revealed a bicuspid aortic valve with severe regurgitation, a moderately enlarged left ventricle, and mildly dilated aortic root. Doppler ultrasonography showed diastolic flow reversal in the brachial arteries. The patient was referred for surgical aortic-valve replacement. Locomotor brachii sign occurs in the setting of severe valvular insufficiency or arteriosclerosis and illustrates the peripheral consequences of aortic regurgitation.