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Aortic stenosis, Diagnosis, Treatment
Aortic stenosis, Diagnosis, Treatment
The largest vessel of the human aorta leaves the left ventricle of the heart. It is arterial blood from the heart under high pressure, secured a strong reduction in the muscle of the left ventricle. Then, in systems of large and small arteries and arterioles oxygen-rich blood reaches every cell in the body. In the systole phase the heart is pumping blood into the aorta and to relax during ventricular diastole, the phase when the pressure drops in the left ventricle, blood is returned into the cavity of the ventricle, at the entrance to the aorta is the aortic valve. It consists of three semilunar valves. In rheumatic and other diseases of the heart valves may thicken and coalesce with each other, they form scars. In this state, the sash is not capable of full disclosure. However, their function is disrupted, and entry into the aorta is narrowed. Narrowing of the entrance to the aorta makes emptying the left ventricle. Requires more effort to push the blood into the aorta and left ventricle hypertrophy due to increased load, its muscle thickens. In this heart defects occur most marked hypertrophy of the heart muscle. Since muscle is a powerful left ventricle, heart for a long time can flow seamlessly to the patient.
However, over time, compensatory reserves are depleted muscles of the left ventricle. This is facilitated by lack of blood supply to the heart muscle, which arises from the discrepancy needs increased muscle oxygen delivery and blood vessels of the heart. The left ventricle is stretched, the size of its inner cavity is increased, while it stretches and the mitral valve, which leads to the emergence of mitral valve insufficiency, and backflow of blood from the left ventricle into the left atrium. Increased pressure in the vessels of the lungs, impaired gas exchange in the lungs, which further worsens the power of the heart muscle. The patient with aortic stenosis complained of palpitations, heart pain, chest pain. Often, these pains are contractive in nature, as in angina. There dizziness, fainting. First, load, and then there is shortness of breath at rest. Decompensated heart defect arises asthma. The patient complained of cough with little phlegm. Sometimes it may be hemoptysis, pulmonary edema can occur. The patient is usually pale. It may be a noticeable ripple in the heart. When the feeling we can determine tremor of the chest.
Aortic stenosis - Diagnosis
To the right of the sternum a rough systolic murmur auscultated. This noise can be heard on the vessels of the neck. On the radiograph shows enlargement of the left ventricle, usually round. An electrocardiogram - an increase of the left ventricle. Echocardiography allows you to see changes in the structure of the aortic valve, set the degree of reduction of the hole from the left ventricle into the aorta, the volume of blood ejected ventricle. Drug treatment of aortic stenosis is reduced to treating the underlying disease, if detected in time. In the later stages of this treatment of heart failure.
Aortic stenosis - Treatment
Surgical treatment of aortic stenosis. Dissection of fused aortic valve is ineffective. It gives a bad long-term results and can be performed only in children, in the absence of gross changes in the leaflets. Therefore, aortic valve replacement is performed through an incision in the aortic wall.
Mortality in this operation, about 3%. Earlier in the decompensated state of heart muscle is not such transactions were made. Now there are new advanced methods of rehabilitation. Even in severe condition of the patient before surgery mortality rate today does not exceed 10-12%.
