Rheumatic aortic stenosis is usually combined with mitral valvular disease and is more common in men. Congenital aortic stenosis is often associated with bicuspid aortic valve.
Valvular aortic stenosis in the prone to calcification, can lead to further progression of stenosis. With significant aortic stenosis, there is an overload of the left ventricle and the heart and brain suffer from insufficient blood supply. Expansion of the ascending aorta of different nature (sclerosis, aneurysm expansion) could lead to a relative aortic stenosis.
This disease characterized by a long asymptomatic. Shortness of breath, angina, dizziness, fainting, weakness arise when long-existing and severe aortic stenosis. At first, they are visible only during exercise. Appearance, pulse, blood pressure remain normal for a long time. Only in the late stage is characterized by pallor, a systolic blood pressure and pulse decrease.
On the gravity defect is judged primarily on the severity of circulatory disorders and the value of the left ventricle. Left ventricular failure develops later, but difficult to treat. It is possible violations of the coronary and cerebral circulation, infective endocarditis, an exacerbation of rheumatic fever, arrhythmias, sudden death. Severe valve calcification is sometimes a cause of embolism.Patients are subject to monitoring at cardio rheumatology. Considerable physical exertion should be avoided. Treatment of heart failure based on general principles, but of little use vasodilators. Nitrates can be effective in angina pectoris. It is possible surgical treatment of valvular disease (usually prosthetic valve). Smaller and unstable effect makes balloon valvuloplastics.
Another disease related to by purchasing heart defects, aortic insufficiency is more prevalent in men. The majority of this defect of rheumatic nature, and then it is usually combined with mitral valvular disease. Infective endocarditis is most often leads to aortic insufficiency. Other causes – syphilitic, rheumatoid arthritis. Rare defect may be due to a congenital defect, trauma, dissecting aortic aneurysm. Hypertension, multiple sclerosis and aortic aneurysm, Marfan syndrome may be accompanied by a relative aortic insufficiency.
In the later stages of worsening stress tolerance develops left ventricular failure, right ventricular, and later joins. The disease is unfavorable for the coronary circulation. Defect can progress as a result of the activity of underlying disease, as well as the gradual stretching of the mouth of the aorta of excess emissions.
The disease is prolonged without any symptom; sometimes the patient is unable to perform even the considerable physical exertion. Early symptom is a feeling of pulsation (in the chest, head, limbs, along the spine), especially after exercise.
Sometimes there is dizziness, a tendency to tachycardia alone, later joined by shortness of breath with a load, nocturnal cardiac asthma, and possible angina. Many patients are pale, extremities warm. Sometimes a noticeable increase in the pulsation of cervical and other peripheral arterial disease, limb movements and head to the beat pulse.
Patients were observed cardio rheumatology, if necessary performed prevention of rheumatism, infective endocarditis. Treatment of heart failure, if it is linked with heart and not with recurrent rheumatic fever, is usually ineffective. Symptomatic effect has diuretics and ACE inhibitors. Cardiac glycosides are used with caution, slowing of the rhythm can impair peripheral circulation. For surgery (prosthetic valve) directs people to severe decompensation.