Aortic Stenosis

Description, Evolution, Therapy.

Aortic Stenosis consists of an obstacle in the passage of blood to the left ventricle in the aorta during the systole.

Aortic stenosis classification:

  • In most cases, aortic stenosis is rheumatic
  • Atherosclerotic
  • Congenital.

Aortic stenosis is a common lesion, often associated with aortic insufficiency. The lesion consists of the thickening of the aortic valves that form a rigid ring. Sometimes there is a calcification of the valves. The stenosis hole imposes a significant ventricular effort on the left ventricle to make it hypertrophied.

Symptoms

Aortic stenosis symptoms:

  • Long-term illness remains subjectively asymptomatic.
  • When stenosis is very tight, cardiac output decreases and episodes of cerebral ischemia, with dizziness, syncope, seizures or sudden death occur. These disorders occur just before the onset of heart failure.
  • At the palpation of the heart, there is a systolic rumbling at the base, listening to intense and severe systolic bloating at the aortic hole, irradiating to the blood vessels of the throat.
  • Pulse is weak, small and slow, and blood pressure low.

Radiological examination of the aortic stenosis shows left ventricular enlargement and sometimes calcifications.

Evolution is good for a long time. When heart failure occurs, the evolution is irreversible and usually fatal, shortly afterwards.

Acute pulmonary edema is often a sign of left ventricular failure. Angina, syncope, sudden deceleration, slow endocarditis and rhythm disturbances darken prognosis.

Treatment

Aortic stenosis treatment is similar to other vascular cardiopathy. During the asymptomatic period, the treatment consists of avoiding high physical strains, prophylaxis of streptococcal injections, prevention of bacterial endocarditis.

In the case of rhythm disorders, antiarrhythmic drugs are administered.

Surgical aortic stenosis treatment is indicated in patients with left ventricular failure, syncope. Surgery is indicated in the patients that they did not exceed 50 years and consists either in commissurotomy or widening the aortic opening, or resecting the aortic valve and replacing it with a Starr-Edwards prosthesis.

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