Defect or anatomy of the anatomical structure of the heart - invariably leads to a deterioration in the functioning of the whole organism.
Moreover, if this vice prevents the normal operation of the largest artery of the circulatory system - the aorta, which supplies blood to all internal organs and systems. This is a stenosis of the aortic valve or aortic stenosis.
Description of the disease
Aortic stenosis is a change in the structure of the aortic valve in such a way that the normal conductivity of the bloodfrom the heart to the aorta. As a result, worsens the blood supply of most internal organs and systems of the human body , "connected" to a large range of blood circulation.
Any healthy person on the border of the left ventricle of the heart and the origin of the aorta from the has a three-folded valve - a kind of "door" that flows blood from the heart into the vessel and does not release it back. Due to this valve, which at full opening has a width of at least 3 cm, the blood from the heart to the internal organs moves only in one direction.
For various reasons, this valve may not open completely, its opening overgrows with a connective tissue and narrows. As a result, the discharge of blood from the heart into the aorta decreases, and the blood that is not let through the vessels stagnates in the left ventricle , which gradually leads to its increase and stretching.
The human heart, thus, begins to work in an abnormal mode, in it the stagnant phenomena are aggravated - all this has the most negative effect on health in general.
Causes and Risk Factors
The disease can be congenital and acquired. The acquired form of the disease develops for various reasons. Classical provocateurs of this disease are:
- organic lesion of valve flaps due to rheumatic diseases - 13-15% of cases;
- atherosclerosis - 25%;
- calcification of the aortic valve - 2%;
- Infectious inflammation of the inner shell of the heart or endocarditis - 1,2%.
As a result of all these pathological effects of , there is a disruption in the mobility of the valve flaps of the : they are joined together, overgrown with connective scar tissue, calcified, and cease to open completely. So there is a gradual narrowing of the aortic orifice.
In addition to the above mentioned reasons, there are risk factors, the presence of which in the history of significantly increases the likelihood of aortic stenosis in humans:
- genetic predisposition to this defect;
- hereditary pathology of the elastin gene;
- diabetes mellitus;
- kidney failure;
- high cholesterol;
- smoking;
- hypertension.
Classification and stages
Disease classified:
- At the site of narrowing: supra-valved, valve-valved and valvular.
- By degree of constriction:
| Degree of stenosis | Change in aortic pressure compared to left ventricle( in mm Hg) | Area of aortic opening( in cm2) |
| I - initial | less than 25 | greater than 1,5 |
| II - moderate | 25-50 | 1-1,5 |
| III - expressed | 50-80 | 0,7-1 |
| IV - sharp | greater than 80 | 0,7-1 |
| V - critical aortic stenosis | greater than 80 | 0.5-0.7 |
It is accepted to distinguish several stages of this cardiac defect:
- Compensation stage - corresponds to the first degree of stenosis. The area of the hole has decreased less than half. There are no clinical symptoms. Pathology can only be discovered by accident.
- The hidden stage of .Clinical signs of the disease are very nonspecific( weakness, dizziness, tachycardia), while the area of the hole has decreased by almost 50%.Stage of first signs of .The first specific signs of heart failure appear. The hole has decreased by more than 50%.
- The stage of severe heart failure , in which even at rest the patient is troubled by specific "heart" symptoms.
- Terminal stage irreversible changes in the body. The lethal outcome is inevitable.
Dangers and complications
According to medical studies, after the first expressed clinical symptoms of the disease and before the death of the patient will undergo no more than 5 years if the disease does not treat .
Typical complications of the disease are:
- heart rhythm disturbances incompatible with life;
- occurrence and development of secondary mitral stenosis;
- acute heart failure;
- thromboembolism.
Symptoms of
The first severe symptoms of cardiac malformation appear even when the aortic lumen is not less than half closed. Compensatory capabilities of the human heart are so great that until this time the disease is almost asymptomatic : a person can feel tired, he often gets dizzy, but he is unlikely to connect these ailments with heart disease.
Specific symptoms that appear in the later stages of the disease are:
- dyspnea - first only after physical exertion, and as the illness worsens and at rest;
- weakness, syncope and premature events;
- pallor of the skin - the so-called "aortic pallor";
- muscle weakness;
- slow and mildly palpable pulse;
- tachycardia and retrosternal pains that radiate between the shoulder blades, in the arm or shoulder;
- frequent headaches;
- hoarseness of voice;
- swelling of the face and legs;
- abdominal pain and ascites( accumulation of fluid in the abdominal cavity).
Diagnosis
In clinical practice, aortic stenosis can be difficult to differentiate from other types of stenosis, aortic insufficiency, and interventricular septal defects.
During the examination the patient uses the following diagnostic methods:
| Diagnostic tool | Symptoms of aortic stenosis |
| Anamnesis history | Characteristic complaints and history of provocative diseases |
| Exterior examination | Specific pallor without cyanosis, facial swelling, muscle and pulse weakness, enlarged liver, symptoms of congestive pulmonary phenomena |
| Heart auscultation | Noise inaortic valve areas, wet wheezing in the lungs |
| Laboratory methods for studying biological materials | urine and blood tests inflammatory |
| Elethe | can be little informative for a long time, later signs of an increase in the left ventricle appear |
| ultrasound of the heart with doppler | change in the valves and valve openings, thickening of the walls of the left ventricle, change in the blood flow rate |
| Radiography | specific "aortic" change in the contours of the heart, change in the pulmonary pattern |
| Cardiac catheterization and coronary angiography | invasive diagnostic techniques that are used before surgery and accurately fix the areaof fishing holes and a change in pressure in the chambers of the heart |
Learn also dangerous than pulmonary stenosis, and how it differs from other acquired vices of a separate material. All about the atresia of the pulmonary valve and its danger to the life of the newborn you can read in this publication.
And about what symptoms are accompanied by an abnormality of Ebstein, find out by clicking here.
Methods of treatment
The possibilities of conservative medical( without surgery) treatment of aortic valve stenosis are limited, as it practically does not affect the pathological mechanism of narrowing the valve clearance.
Drug therapy is used only to prevent possible complications and alleviate the symptoms of the disease. To this end, prescribe:
- dopaminergic drugs( Dopamine, Dobutamine);
- vasodilators( Nitroglycerin);
- cardiac glycosides( Digoxin, Strofantin);
- diuretics( Veroshpiron, Furosemide);
- antihypertensive agents( lisinopril);
- antibiotics for the prevention of endocarditis.
The following surgical procedures are being practiced:
- Baloon valvuloplasty is a minimally invasive, radical method in which the aortic augmentation is expanded by injecting air into a special balloon that is brought to the desired location through the main vessel. The method is rarely used in cases of acquired ailment - mainly in preparation for the subsequent open surgery, in elderly and weakened patients.
- Plastic interlocking valve flaps on the open heart .A complex operation, which requires the connection to the apparatus of artificial circulation. Practice rarely.
- Prosthetics of aortic valve using biological or mechanical implants. A widely practiced method of radical treatment of aortic stenosis. It can be used even for the treatment of elderly people, it gives good results in case of severe disease.
Learn about aortic valve stenosis from a video clip:
Forecasts and prevention measures
Isolated aortic stenosis under condition of proper treatment gives a favorable outlook for the future of .Patients with such a disease can long remain able-bodied, while limiting their physical activity.
Surgical intervention in this pathology almost always guarantees a favorable outcome. Mortality even in severe cases in weakened patients does not exceed 10% in this case.
All patients, regardless of the methods and results of treatment, need to revise their lifestyle in favor of:
- physical work restrictions;
- rejection of bad habits;
- is a salt-free diet.
It should be remembered that aortic stenosis after the appearance of the first clinical signs does not give a person much time to think about and search for alternative sparing methods of treatment. Decision in favor of life in this case - immediate appeal for help to a cardiologist and consent to an operation if necessary. Only in this way will the patient be insured against death in the next few years.
