Aortic stenosis, or stenosis of the aortic orifice, is a congenital or acquired disease characterized by a narrowing of the outflow tract of the left ventricle in the aortic valve region, which causes difficulty in the outflow of blood from the left ventricle, and also contributes to a sharp increase in the pressure gradient between the aorta and the ventricle, as the Internet edition reports.. net Types and causes of aortic stenosis Three types of aortic stenosis are distinguished:.

valvular (congenital or acquired);

supravalvular (only congenital);

subvalvular (congenital or acquired).

The main causes of acquired aortic stenosis are:.

aortic atherosclerosis;

degenerative changes of valves with their subsequent calcification;

rheumatic valve disease (the most common cause of the disease);

infectious endocarditis.

Rheumatic damage to the valve cusps (rheumatoid endocarditis) provokes a contraction of the valve cusps, as a result they become rigid and dense, which is the reason for the narrowing of the valve opening. Often there is calcification of the aortic valve, which contributes to an even greater decrease in leaflet mobility.

In infectious endocarditis, similar changes are observed leading to the development of aortic stenosis. Often the causes of the formation of the disease are systemic lupus erythematosus and rheumatoid arthritis.

Atherosclerosis of the aorta is accompanied by severe degenerative processes, sclerosis, stiffness and calcification of the valves of the fibrous valve ring, which also complicate the outflow of blood from the left ventricle.

Sometimes in elderly people, the cause of aortic stenosis is primary degenerative valve changes. This phenomenon is called "

Congenital aortic stenosis occurs as a result of defects and abnormalities in valve development. In the late stages of the development of the disease, pronounced calcification joins the symptoms of aortic stenosis, which exacerbates the course of the disease.

Thus, in all patients, to a certain degree of aortic stenosis, regardless of the cause, aortic valve deformity and severe calcification are observed.

Symptoms of aortic stenosis Depending on the degree of aortic stenosis, patients may not experience any discomfort for a long time, t. for a long time the disease has no symptoms.

With a pronounced narrowing of the valve opening, patients begin to complain of the appearance of angina attacks, fatigue and weakness during physical exertion, fainting and dizziness with a rapid change in body position, shortness of breath. In severe cases, a symptom of aortic stenosis is asthma attacks (pulmonary edema or cardiac asthma).

In patients with isolated stenosis of the aortic orifice, complaints may occur associated with the appearance of signs of right ventricular failure (severity in the right hypochondrium, edema). These symptoms of aortic stenosis occur with significant pulmonary hypertension due to mitral valve defects in combination with aortic stenosis..

With a general examination of the patient, he has a characteristic pallor of the skin.

Diagnosis of aortic stenosis The main methods of instrumental diagnosis of aortic stenosis are:.

ECG;

X-ray study;

Echocardiography;

Cardiac catheterization.

Treatment of aortic stenosis In severe aortic stenosis, medication is usually ineffective. The only radical treatment is aortic valve replacement. Already after the onset of symptoms of the disease, the chances of surviving without surgery are drastically reduced. On average, patients after the onset of symptoms such as heart pain, signs of left ventricular failure, fainting, live no more than five years.

After the diagnosis of “aortic valve stenosis” is established, the patient is recommended to take preventive measures against infectious endocarditis.

With asymptomatic aortic stenosis, drug treatment is aimed at maintaining sinus rhythm, preventing coronary heart disease and normalizing blood pressure.

After the appearance of complaints, when it is impossible to carry out the operation, medication is prescribed. So, in the presence of heart failure with the help of medicines, they try to eliminate stagnation in the pulmonary circulation by taking diuretics. However, their too active use can contribute to the development of excessive diuresis, hypovolemia and arterial hypotension. With systolic dysfunction of the left ventricle, Digoxin is prescribed as a symptomatic agent, especially with atrial fibrillation.

With aortic stenosis, vasodilators are contraindicated for the patient, since their use can lead to fainting. However, in severe heart failure, careful administration of sodium nitroprusside is allowed.

With congenital aortic stenosis in children, aortic balloon valvuloplasty can be used. This method allows you to reduce the maximum transvalvular gradient by 65%, however, mainly this technique requires reoperation for 10 years. After valvuloplasty, patients may develop aortic insufficiency.

The most effective treatment for aortic stenosis is the surgical method of aortic valve replacement.. Aortic valve replacement is indicated for severe aortic stenosis in the following cases:.

fainting, angina pectoris, or heart failure;

in combination with coronary artery bypass grafting;

in combination with operations on other valves.

Surgical treatment of aortic stenosis significantly improves patient well-being and survival prognosis. It can be successfully carried out even in elderly patients without the risk of developing serious pathologies.. Autografts, allogeneic prostheses, allografts, mechanical prostheses or pork bioprostheses and bovine pericardial prostheses are used for prosthetics..

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