Stenosis of the aortic aorta( aortic stenosis) and all its features

The human heart is a complex and subtle but vulnerable mechanism that controls the operation of all organs and systems.

There are a number of negative factors, beginning with genetic disorders and ending with the wrong way of life, which can cause malfunctioning of this mechanism.

Their result is the development of diseases and pathologies of the heart, including stenosis( constriction) of the aortic estuary.

General information

Stenosis of the aortic estuary( aortic stenosis) is one of the most common heart diseases in modern society. It is diagnosed in every fifth patient of at the age of 55 years, with 80% of the patients being men .

Patients with this diagnosis have a narrowed aperture, which leads to a violation of the blood flow to the aorta from the left ventricle. As a result, the heart has to make considerable efforts to pump blood into the aorta through a diminished orifice that

Causes and Risk Factors

Aortic stenosis can be congenital( occurs as a result of an abnormal intrauterine development), but more often it develops in the course of a person's life. The causes of the disease include:

• heart diseases of a rheumatoid nature, which usually arise as a result of acute rheumatic fever due to infections caused by a certain group of viruses( group A hemolytic streptococci);
• atherosclerosis of the aorta and valve is a disorder that is associated with impaired lipid metabolism and cholesterol deposition in the vessels and valve flaps;
• degenerative changes in the heart valves;
• infective endocarditis.

Classification and stages of

Aortic stenosis has several forms that are distinguished by different criteria( localization, degree of blood flow compensation, degree of narrowing of the aortic aperture).

• for the localization of constriction aortic stenosis can be valve, nadkvalpannym or podklyapannym;
• on the degree of compensation of blood flow( by how much the heart manages to cope with the increased load) - compensated and decompensated;
• in the degree of narrowing of the aorta secrete a moderate, pronounced and critical form.

The course of aortic stenosis is characterized by five stages:

• I stage ( full compensation).Complaints and manifestations are absent, vice can only be determined through special studies.
• II stage ( latent blood flow deficiency).The patient is concerned about mild malaise and fatigue, and signs of left ventricular hypertrophy are determined radiographically and by ECG.
• III stage ( relative coronary insufficiency).There are pains in the chest, fainting and other clinical manifestations, the heart increases in size due to the left ventricle, on the ECG - its hypertrophy, accompanied by signs of coronary insufficiency.
• IV stage ( severe left ventricular failure).Complaints of severe malaise, stagnation in the lungs and a significant increase in the left heart.
• V stage , or terminal. In patients, progressive failure of both the left and right ventricles is noted.

More about the disease, see this animation:

Is it scary? Dangers and complications of

The quality and life expectancy of a patient with aortic stenosis depends on the stage of the disease and the severity of the clinical signs of .In people with a compensated form without expressed symptoms, there is no direct threat to life, but the symptoms of left ventricular hypertrophy are considered to be prognostically unfavorable.

In patients with a "classical triad"( angina, syncope, heart failure), life expectancy rarely exceeds five years. In addition, has a high risk of sudden death of in the last stages of the disease - approximately 25% of patients diagnosed with stenosis of the aortic aorta die suddenly from fatal ventricular arrhythmias( usually they are people with severe symptoms).

The most common complications of the disease include:

• chronic and acute left ventricular failure;
• myocardial infarction;
• atrioventicular blockade( occurs relatively rarely, but can also lead to sudden death);
• edema and congestion in the lungs;
• systemic embolisms caused by slices of calcium from the valve can cause strokes and visual impairment.

Symptoms of

Often, signs of stenosis of the aortic aorta do not manifest themselves for a long time. Among the symptoms that are characteristic for this disease, are:

• Shortness of breath .Initially, it appears only after physical exertion and completely absent at rest. Over time, dyspnea occurs in a calm state and intensifies in stressful situations.
• Chest pain .Often they do not have exact localization and are manifested mainly in the heart. Sensations can be oppressive or stitching, last no more than 5 minutes and increase with physical stress and stress. Pains of angina pectoris( acute, irradiating in the arm, shoulder, under the scapula) can be noted even before the appearance of pronounced symptoms and are the first signal of the development of the disease.
• Fainting .Usually observed during exercise, less often - in a calm state.
• Rapid heartbeat and dizziness .
• Strong fatigue , reduced performance, weakness.
• Sensation of asphyxiation, which can be worse when lying down.

When should I see a doctor?

Often the disease is diagnosed accidentally ( for preventive examinations) or in later stages because patients write off the symptoms for fatigue, stress or adolescence.

Diagnosis

Diagnosis of stenosis of the defect is complex and includes the following methods:

• Collecting anamnesis .An analysis of the patient's complaints, past medical history and family history( cases of heart disease or sudden death from the next of kin).
• Exterior inspection. Patients have a pale and cyanotic skin, noises in the heart and wheezing in the lungs, and peripheral pulse on the radial arteries is weak and rare.
• Auscultation of of aortic stenosis. The method consists in listening to the tones and rhythms of the heart - with aortic stenosis II tone is usually weakened or completely absent, as well as systolic and diastolic noises.



• General blood test .It is performed in order to determine the level of erythrocytes, platelets, leukocytes, as well as the level of hemoglobin.
• General analysis of urine .It provides an opportunity to identify violations that can affect the course of the disease.
• Electrocardiography .Method for assessing the electrical activity of the heart, which allows to identify violations of his work.
• Echocardiography of the .Ultrasound examination determining the degree of aortic narrowing and the most significant heart function. Coronary angiography with aortography .Invasive procedure, which involves penetration into the vessels of the hands and feet for the examination of the vessels of the heart and aorta.
• Tests with physical loads .Load tests include a walking test, a stationary bike and a treadmill.

Treatment methods

There is no specific aortic stenosis therapy, therefore the treatment strategy is chosen based on the stage of the disease and the severity of symptoms of .In any case, the patient must register with the cardiologist and be under strict supervision. It is recommended to pass the ECG every six months, rejection of bad habits, diet and strict regime of the day.

Patients with I and II stages of the disease are prescribed medication for normalizing blood pressure, eliminating arrhythmias and slowing the progression of stenosis .Usually it includes the intake of diuretics, cardiac glycosides, drugs that reduce blood pressure and heart rate.

The radical methods of the initial stages of aortic stenosis include cardiac surgery. Balloon Valvuloplasty ( a special balloon is injected into the aortic aperture and then inflated mechanically) is considered a temporary and ineffective procedure, after which, in most cases, relapse occurs.

In childhood, doctors usually resort to valvuloplasty ( surgical valve plastic) or operation of Ross ( pulmonary valve transplantation to the aortic position).

In the III and IV stages of aortic stenosis, conservative medical treatment does not give the proper effect, therefore patients undergo prosthetic repair of the aortic valve. After the operation, the patient must for life-long use of drugs for the dilution of blood , which prevent the formation of blood clots.

Prophylaxis of

There are no methods to prevent congenital stenosis of the aortic aorta or its intrauterine diagnosis.

Prophylaxis measures acquired by in a healthy lifestyle, moderate physical exertion and the timely treatment of , which can provoke aortic narrowing( rheumatic heart disease, acute rheumatic fever).

Any heart disease, including aortic stenosis, carries a potential danger to life. To prevent the development of cardiac pathologies and vices, it is very important for to take a responsible attitude to one's health and lifestyle, and regularly undergo preventive examinations that can detect diseases at the early stages of their development.