Hill's sign

The marked elevation of popliteal systolic arterial pressure compared with brachial systolic pressure (≥20-40 mmHg, and often ≥60 mmHg) in patients with chronic aortic regurgitation, reflecting increased stroke volume and widened pulse pressure transmitted to the peripheral arteries.

Causes

• Age-related aortic valve degeneration

• Congenital bicuspid aortic valve

• Aortic root dilation (connective tissue disorders)

• Aortic aneurysm

• Infective endocarditis causing valve destruction

• Rheumatic heart disease

• Aortic dissection involving the aortic valve

• Trauma affecting the aortic valve or root