Internal illnesses. Aortic valve defects (most important)

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Internal illnesses. Aortic valve defects (most important)

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13. VALVAL VALVES OF THE AORTIC

Aortic valve insufficiency is the incomplete closure of the semilunar cusps of the aortic valve, which leads to a backflow of blood from the aorta into the left ventricle during its diastole (aortic regurgitation). Men are more often ill.

Etiology. Rheumatism, atherosclerosis, infective endocarditis, syphilitic mesaortitis, congenital anomalies, diffuse connective tissue diseases, and injuries are important.

Pathogenesis. As a result of incomplete closure of the aortic valve cusps in diastole, blood flows back from the aorta into the cavity of the left ventricle. There comes a volumetric diastolic overload of the left ventricle, its hypertrophy.

Clinic. There are no clinical manifestations in the compensation stage. In the stage of circulatory insufficiency, pulsation of large arteries, "carotid dance", Musset's symptom, positive capillary pulse, pulsation of pupils, dizziness, fainting, pain in the heart area are noted.

Cyanosis is pronounced, the borders of the heart are enlarged to the left. A diastolic murmur is heard in the second intercostal space on the left, and an enlarged, painful liver is palpated.

Shortness of breath and suffocation occur in the stage of decompensation.

Diagnostic study. ECG examination, X-ray examination, Doppler echocardiography examination, echocardiography examination.

Treatment. Cardiac glycosides are used, prescribed with caution due to slowing heart rate and increasing cardiac output, vasodilators to deposit blood in the vascular system and reduce regurgitation.

During surgical treatment, aortic valve replacement is performed. Flow. In the stage of compensation, the course is long, in the stage of decompensation it is rapidly progressing.

Forecast. With timely treatment - relatively favorable.

Aortic stenosis is a heart disease caused by narrowing of the aortic ostium. It is rare in isolated form, more often in combination with aortic valve insufficiency. Most often men are ill.

Etiology. Valvular narrowing of the aorta with rheumatism, atherosclerosis, infective endocarditis, gummous syphilis, congenital narrowing of the aortic orifice, or subvalvular (subaortic) narrowing with hypertrophy of the interventricular septum.

Pathogenesis. As a result of the narrowing of the aortic orifice, the systole time of the left ventricle is prolonged.

Clinic. There are no clinical manifestations in the compensation stage. With physical exertion, emotional stress, pain in the region of the heart (like angina pectoris), shortness of breath, dizziness, a tendency to faint, and headache may appear.

With a decrease in the contractile function of the left ventricle, attacks of cardiac asthma may occur.

Diagnostic study. ECG examination, X-ray examination, echoCG examination.

Treatment. Treatment of the underlying disease, angina pectoris (nitrates, calcium channel blockers), heart failure. Surgical treatment - aortic commissurotomy, aortic valve replacement.

Forecast. Under compensated conditions - favorable.

Author: Myshkina A.K.

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