In this article, we will understand what it is - aortic stenosis.
Heart defects are diseases that are characterized by anatomical changes in large vessels or valvular apparatus. The congenital defects present in the child immediately at birth, and, in addition, acquired ones that occur in vivo as a result of a disease, are distinguished.
ICD-10 (international classification of diseases of the tenth revision) aortic stenosis is coded under the number I35.0, the disease refers to non-rheumatic lesions of the aortic valve. If there is such a defect, the valves at the valve can splic together, which will interfere with normal blood flow. Against the background of aortic adhesions at the time of systole (that is, the contraction process), blood from the left ventricle hardly enters the aorta. For this reason, the myocardium can significantly hypertrophy, and the left ventricle will stretch.
Many are interested in what it is - aortic stenosis.
Degrees of pathology
There are several degrees of severity of the disease in question. They, as a rule, are determined by the size of the opening of the valve cusps at the moments of systole and the difference in pressure. It should be noted that the pressure gradient is an indicator indicating the difference in the pressure intensity. This indicator is determined by ultrasound or by cardiac catheterization. The following severity levels are distinguished:
- With an initial degree, aortic stenosis is negligible. The valve opening is at least 1.2 square centimeters. The gradient is thirty-five millimeters of mercury.
- The next degree is characterized as moderate aortic stenosis. With its development, the size of the valve hole is about 0.75 square centimeters with a pressure gradient of up to sixty-five millimeters of mercury.
- With the third degree of aortic stenosis, the size of the valve opening does not exceed 0.74 square centimeters, and the gradient is more than sixty-five millimeters of mercury.
- The fourth degree of the pathology under consideration is called critical stenosis, against which the narrowing is 0.7 cm 2 and the pressure gradient exceeds eighty millimeters of mercury.
The degree of aortic valve stenosis we examined.
Pathology stages
In addition, it is necessary to pay special attention to the stages of development of stenosis. It is worth noting that absolutely each of them has a certain symptomatology that helps to establish the most accurate diagnosis. So, there are four stages of this pathology:
- The compensation stage is an asymptomatic period. At the same time, the heart can completely cope with the increase in load, and the symptomatology can not manifest itself for several decades.
- Subcompensation stage. During this period, the first symptoms occur. These appear mainly against the background of severe physical exertion, especially one that is unusual for the patient.
- Against the background of the decompensation stage, severe and severe heart failure is observed. Symptoms in this case are manifested not only after a slight load, but also at rest.
- The terminal stage, as a rule, occurs due to a complication or catastrophic change in the heart. At this stage of the development of pathology, the onset of death is not excluded.
Reasons for the development of pathology
Aortic stenosis (according to the ICD - International Classification of Diseases - encoded as I35.0) is often found in older people. As a rule, it is observed in every tenth patient. In more than eighty percent of cases, stenosis can occur due to age-related changes in valve flaps. Ten percent of cases are associated with rheumatic diseases.
A factor affecting the appearance of this pathology is also the presence of a congenital anomaly in the form of a bicuspid aortic valve, which often causes stenosis in a third of patients with this feature. A separate role is assigned to heredity, bad habits, high blood cholesterol and arterial hypertension.
What is it - aortic stenosis - not everyone knows.
Symptoms of the disease: first degree
Symptoms of diseases largely depend on how narrow the aortic opening is, that is, directly on the degree of the disease. The first stage of the pathology is characterized by a rather long, and at the same time asymptomatic course, for example, more than ten years. Often this pathology can be detected during an examination aimed at searching for other diseases or in the process of undergoing medical examinations.
Immediately after the detection of stenosis, the patient is put on a dispensary account with a cardiologist, who (through regular examinations) can monitor the development of pathology and prescribe treatment in a timely manner, preventing the occurrence of complications. Over time, shortness of breath may occur, and fatigue increases during exercise. The first signs of heart failure with mitral aortic stenosis are also possible.
Symptoms in the second degree
When the pathology under consideration moves to the second level, and, in addition, during physical work, the patient may experience dizziness along with short-term loss of consciousness and exertional angina (against the background of the last manifestation, patients complain of pressing pain and discomfort behind the sternum). It is also likely night dyspnea, and in more severe situations, an attack of cardiac asthma may join along with pulmonary edema.
Symptoms of the third degree
At this stage, the symptoms can increase and disturb not only with a pronounced load, but also in a state of absolute rest. Too difficult outflow of blood can provoke an increase in intracardiac pressure. In addition, pressure in the pulmonary vessels also increases. In addition, choking may occur, and further asthma attacks, which may be permanent, are not ruled out.
Symptoms of aortic stenosis should not go unnoticed.
Fourth degree stenosis
As hypertrophy develops in the heart chambers, blood stasis increases. The same picture can be observed in other vessels, for example, in the liver, kidneys, lungs and muscles. Increasingly, pulmonary edema may occur, which is life-threatening to patients. So-called cardiac edema is not excluded (for example, when the lower extremities swell) along with ascites (in this case we are talking about the accumulation of fluid in the abdominal cavity), pain in the hypochondrium on the right. It is important to emphasize that in the event that a person notes the above symptoms in himself, then you need to seek the advice of a qualified cardiologist.
Possible complications
Aortic stenosis in cases of lack of proper therapy leads to heart failure. This may increase gradually due to the fact that it is becoming increasingly difficult for the left ventricle to push blood into the aorta. Subsequently, the myocardium can cope more difficult with increasing loads, which can provoke atrophy of the left ventricle, and then a similar process will be observed in the muscle of the entire organ. The development of aortic valve stenosis increases the susceptibility of the endocardium to various viruses and bacteria, as a result of which the development of endocarditis is not ruled out. It is important to emphasize that immediately before a series of medical interventions, after consulting a doctor, antibiotics are required to prevent endocarditis. For example, this should be done before the tooth extraction procedure.
Diagnosis of the disease
Usually, the cardiologist's first suspicion arises immediately after hearing a characteristic pathological heart murmur during auscultation. Further, additional research methods are prescribed in order to confirm or refute the diagnosis. In diagnosing this disease, the following methods are used:
- An electrocardiogram provides an opportunity to gain an idea of the general condition of the heart. In the case of the presence of the diagnosis in question, an increase in the left ventricle is observed in patients.
- Thanks to an x-ray of the chest, the borders of the heart are outlined, which allows you to notice the expansion of the cavities, which is typical for stenosis. This diagnostic technique provides information about the condition of the lungs, also suffering from heart failure (while fluid often accumulates in them).
- Ultrasound examination of the heart. Using this method, you can not only detect valve stenosis, but also monitor the blood flow in the heart. Ultrasound examination is the most popular diagnostic method due to the maximum information content, it is absolutely safe and very inexpensive.
- Performing cardiac catheterization. As part of this procedure, barium sulfate (contrast medium) is introduced through a catheter inserted into the bloodstream through a small incision in the artery. As a result, a series of x-rays allows the doctor to evaluate the condition of the heart along with patient pressure.
Medical advice for aortic stenosis
In the event that the person’s medical record contains such a diagnosis, it is necessary to exclude any sports activities along with heavy physical exertion, even if the symptoms of the disease do not interfere with life. At least once a year, you need to visit a cardiologist to undergo prophylaxis of the progression of endocarditis and the described disease.
What is the treatment for aortic valve stenosis?
Conservative therapy
These drugs will definitely not expand the narrowed opening, but they will certainly contribute to improving blood circulation and the general condition of the heart. So, as part of the conservative treatment of aortic stenosis of the heart, the following medications are used:
- Dopaminergic drugs in the form of "Dopamine."
- The use of diuretics, for example, a drug called "Trifas".
- Treatment with vasodilators, for example, Nitroglycerin.
- The use of antibiotics, for example, Cephalexin.
It is required to pay attention to the fact that absolutely all medications are taken exclusively according to the doctor’s prescriptions and after prescribing the necessary dosages, which are related to the degree and stage of the disease.
Operation
Surgical procedures are most effective for aortic stenosis. The operation in this case must be carried out before the development of insufficiency of one of the ventricles, otherwise the onset of certain complications is very high. The operation is prescribed to patients in the presence of a moderate or severe degree of pathology. Surgical treatment can be prescribed to the patient against the background of clinical symptoms.
Valvuloplasty (dissection of adhesions and adhesions in the valves) is usually performed in patients with moderate stenosis. In the event that stenosis is severe, especially if it is combined with heart failure, then a prosthetic repair of the damaged valve will become a more appropriate treatment technique.
Prophylaxis
Aortic stenosis can usually be prevented by preventing rheumatism, atherosclerosis, and endocarditis. It is very important to further eliminate all risk factors.
Appointment of a special diet
Productive therapy of aortic stenosis (according to ICD-10 I35.0) is not possible without proper diet. Certain foods should be completely excluded from the diet. For example, you should not eat excessively spicy, salty, smoked and fatty foods. Foods such as hamburgers along with shawarma, french fries and so on are not suitable for nutrition with this diagnosis.
It is necessary to exclude drinks with gas from the diet along with desserts containing dyes. Do not smoke or take alcohol. Surely in the diet of such a patient should be present all kinds of skim and sour-milk products along with fruits, vegetables, their juices and cereals. It is important to pay attention to the following: despite the diet, the human body needs a complex of vitamins and minerals. In this situation, synthetic vitamin complexes will be the best solution.
Features of aortic stenosis in children
At the initial stage of the disease, children behave the same as before, and parents very often as a result of this do not go to the doctor. Minor symptoms in the form of a slight pallor, a bad sucking reflex and frequent spitting up in infants do not even prompt parents to seek the advice of a cardiologist. In adolescence, the course of this disease, as a rule, is similar to the course in adult patients.
Features of the disease in pregnant women
Due to the fact that the bearing of the fetus makes the human heart work in an enhanced mode, in the presence of severe stenosis, women are prescribed termination of pregnancy. This is due to the high probability of the death of the child and mother, including. In turn, the risks of developing a child with congenital heart disease are more than twenty percent. In case of abortion (as in the cases of its preservation), endocarditis is prevented with antibiotics.
Reviews
The reviews reported that aortic stenosis is a rather dangerous and serious disease. People note that most often the treatment of this pathology is not complete without surgery.
Unfortunately, according to experts, such a complicated operation does not guarantee patients a 100% recovery. Among other things, it is reported that with this diagnosis, patients are forced to constantly take certain supporting drugs. In addition, the service life of the valve used during the operation is limited.
Thus, it is possible that a person may need to conduct another operation. It is also noted that the opening of the replacement valve, as a rule, is not as wide as natural and by no means always can reduce pressure on the heart.
We examined what it is - aortic stenosis.