Aortic valve disease - causes, symptoms, diagnosis, treatment, pathology
Aortic heart disease: causes, symptoms, treatment
Aortic heart defects are pathologies provoked by a violation of the structure or functioning of the mitral valve. They manifest themselves in the form of aortic (mitral) insufficiency (partial closure of the aorta with a mitral valve), stenosis (narrowing of the aortic opening) and a combination of stenosis and insufficiency (combined - a combination of partial closure of the valve leaflets and narrowing of the aortic opening).
Such pathologies can be detected in the first day of life or develop later under the influence of other diseases. They can lead to malfunctions of other body systems and disorders of hemodynamics.
Aortic defect in the form of insufficiency of the main artery of the heart
Pathology consists in the partial closure of the valve leaflets. As a result, some of the blood returns to the left ventricle, causing it to stretch and further wear out. Violation of hemodynamics leads to stagnation of blood in the vessels of the lungs.
The reasons for this type of aortic heart disease
Pathology is congenital and acquired. With congenital, one of the valves is absent or dystrophy, different sizes of valves, holes in one of them. The disease may not be detected in early childhood, but in the future it will certainly manifest itself.
Acquired aortic insufficiency can be triggered by infectious diseases (pneumonia, tonsillitis, sepsis, syphilis). Microbes often infect the endocardium. This leads to proliferation of connective tissue, deformation and incomplete closure of its valves.
In addition, autoimmune diseases (rheumatism, lupus erythematosus) can be a provoking factor. Pathologies of this kind provoke the proliferation of connective tissue, which leads to the above-described consequences.
Sometimes aortic insufficiency occurs due to hypertension, atherosclerotic changes in the aorta, calcification of the valve, stroke in the heart, expansion of the aortic root (age-related changes)... The listed reasons can also lead to rupture of the valves, which is accompanied by a rapid deterioration in health.
Symptoms and treatment of aortic heart disease (failure) of the heart
Sometimes the disease does not manifest itself for decades, but when the organ's compensatory abilities deteriorate, the following conditions appear:
- Dizziness when changing position of the body;
- Feeling of heartbeat;
- Throbbing headaches;
- Feeling of pulsation in large vessels;
- Pain in the heart;
- Rapid fatigability;
- Shortness of breath at minimal exertion;
- Swelling of the feet;
- Confusion, fainting;
- Heaviness in the right hypochondrium.
During the examination, the doctor determines pallor of the skin, tachycardia, the difference between pressures, pulsation of the uvula and tonsils, heart hump, noises during ventricular contraction, enlargement of the heart.
To confirm the diagnosis, additional studies are prescribed, which include: ECG, phonocardiography, echocardiography, Doppler, X-ray.
The first and second stages of failure do not require specific therapeutic / cardiological treatment. It is required to regularly conduct ultrasound and ECG, to change the lifestyle. The third and fourth stages of the disease require medication. Medications such as calcium antagonists, diuretics, vasodilators, beta-blockers, cardiac glycosides are prescribed.
Surgical intervention is used for congenital pathology when the patient reaches 30 years of age or in case of a sharp deterioration in the condition. With an acquired disease, the time of the operation depends on the severity of the pathological changes. The indication for surgery is a significant deterioration in the function of the left ventricle, its increase is more than 6 cm, deterioration of health and a return flow of 25% of blood, a return of more than 50%.
- intra-aortic balloon counterpulsation - performed with slight deformation of the valves, blood flow no more than 30%;
- valve implantation - in case of significant changes, up to 60% of blood is injected, metal and silicone artificial valves are used.
Pathology is accompanied by a narrowing of the orifice of the aortic lumen, which leads to incomplete flow of blood from the ventricle. As a result, the heart grows in size, blood pressure rises, the person suffers from fainting and heart failure.
Causes of aortic stenosis
Pathology, like the previous one, is congenital and acquired.
The first is accompanied by the presence of a cushion of muscle fibers above the aortic valve; the presence of only one or two valves; the presence of a membrane with a hole under the valve.
This form of the disease may not showoccur in early childhood, but later becomes more pronounced.
Acquired stenosis occurs with infectious diseases that lead to endocarditis, autoimmune pathologies and age-related changes.
That is, the reasons are almost identical, as in the case of aortic insufficiency.
Symptoms of aortic stenosis
The disease is characterized by an asymptomatic course in the early stages.
When the gap between the valve and the aorta becomes larger, the person experiences the following symptoms:
- Feeling of heaviness in the chest;
- Shortness of breath when lying down and after exertion;
- Pain in the heart;
- Weakness, dizziness, fainting;
- Fatigue, nocturnal cough;
- Swelling of the feet;
- Pale skin;
- Weak pulse;
- Murmur of blood flow in the aortic valve;
- Indistinct valve closing sound.
The diagnostic process includes ECG, X-ray, Doppler sonography, transthoracic and transesophageal echocardiography, and, if necessary, cardiac catheterization.
In the initial stages, treatment consists in prescribing drugs that improve the supply of oxygen to the myocardium, normalizing the rhythm and pressure. The complex of therapy, as a rule, includes antiangial, diuretic and antibiotics.
If shortness of breath and weakness increase, surgery is indicated. Surgery is required for moderate to severe stenosis. A contraindication to its implementation is the presence of a number of concomitant pathologies and the patient's age over 70 years.
In childhood, aortic balloon valvuloplasty is more often performed. This operation is minimally invasive. It is also performed up to 25 years of age and in the presence of contraindications for valve replacement in older patients. The disadvantage of this method is the possibility of re-narrowing the aortic lumen. As with aortic regurgitation, valve implantation is possible for stenosis.
Combined (combined) aortic heart disease
This pathology is a lesion of both valves - mitral and aortic. It is manifested by stenosis of one and insufficiency of the other, or double stenosis. Mitral-aortic heart disease is manifested by cyanosis, palpitations, dyspnea, rhythm interruptions, angular pain, hemoptysis. Diagnostics involves ECG, echocardiography, radiography. Can apply surgical treatment - valve replacement, valve-sparing correction, commissurotomy.
Concomitant aortic heart disease: causes and symptoms
Almost always the disease has a rheumatic etiology, associated with myocarditis or endocarditis. Sometimes occurs after septic endocarditis or atherosclerosis.
Defect with a predominance of mitral stenosis is accompanied bytachycardia, arrhythmia, shortness of breath, hemoptysis (congestion), pulmonary hypertension.
With a predominance of aortic stenosis, the patient suffers from increased fatigue, muscle weakness, palpitations, angina pectoris, cardiac asthma.
With a predominance of aortic insufficiency, dizziness, headaches, temporary visual disturbances, fainting, arterial hypotension occur. With the dominance of mitral insufficiency, shortness of breath, palpitations, atrial fibrillation, anginal pain, acrocyanosis, cough with hemoptysis occur.
Conservative therapy includes cardiac glycosides, antiarrhythmics, anticoagulants, diuretics, calcium antagonists, peripheral vasodilators, oxygen therapy, exercise therapy. If necessary, an operation is performed, the version of which depends on hemodynamic parameters and the degree of limitation of valve mobility.
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