Insufficiency of aortic valve 1, 2, 3 degrees: signs, symptoms, diagnosis, treatment

The human body is unique. However, sometimes there are situations when a certain body performs its functions inferiorly. It is such a structure disorder - aortic valve insufficiency - the topic of this article.

Terminology

Initially, you need to understand the terms that will be used in the article presented. So, what is the insufficiency of the aortic valve? This is a violation of the work of this body, as a result of which its doors are not completely closed. This leads to a problem such as dropping blood from the aorta back into the left ventricular ventricle. This occurs during diastole - the process of filling the heart with blood. Than it is fraught? So the human body receives less than the volume of blood necessary for normal work. As a result, the load on the heart is increased in order to compensate for this shortcoming.

Speaking generally, at first, while the body is young and full of strength, aortic valve insufficiency most often does not bring any problems. The only thing, the heart may grow a little in size, to be able to compensate for the shortage of blood. Symptomatic at first is completely absent, and the patient may not even guess about the existence of the problem. Later, dyspnea begins to appear, and fatigue is increased. To cope with this disease, the patient can be sent to an operation to replace the aortic valve.

Problem in figures

Scientists note that the problem of such a problem as aortic valve insufficiency is most often affected by males. If we consider the interest, the number of deaths from this pathology, in the case of all the dead with various heart problems, is about 14%. If to consider this disease, approximately in 4% of cases the aortic valve insufficiency is observed in the pure form, and in 10,3% of cases - in a complex with other diseases of heart.

Causes

If to speak in general, the reason for the development of this problem in 2/3 of the cases is the rheumatic lesion of the valves. Less common is infectious endocarditis. Also, scientists distinguish two groups of causes, which are divided into chronic and acute.

Causes of chronic insufficiency

In this case, physicians identify several important causes that can cause chronic processes:

• Congenital heart diseases. Children can be born with only one or two valves, which causes many problems and difficulties during the pumping of blood by the heart.
• The processes of aging. That is, the aortic valve can wear out over time, wear out.
• Rheumatic fever , which causes scarring valves valve, which prevents them fully closed.
• Infectious processes in the heart , when vegetation (whole colony of bacteria) "eat" the valve flaps, or, simply accumulating on the valves, prevent them from normally closing.
• Aortic enlargement , when its bulb is stretched so much that the valves simply can not completely close.
• Treatment of various problems that can cause aortic valve insufficiency. For example, radiation therapy or the use of "Phentermine" - a drug for weight loss, which was taken out of use at the end of the 20th century. According to research of scientists, its use could cause various heart problems, including aortic valve insufficiency.

Causes of acute insufficiency

Physicians among the causes of aortic valve insufficiency also distinguish such diseases as endocarditis (infectious organ damage), aortic dissection (as a result of which the blood flows through the resulting ruptures). Sometimes patients after a surgery to replace the aortic valve also develops its insufficiency. To the acute causes of this problem is also the traumatism of the chest (for example, during a car collision, when a person strikes heavily on the dashboard). This often also leads to damage to the aortic valve.

Symptomatic of the problem

What are the signs of aortic valve failure, which can be used to determine if there is a problem? As it was mentioned above, initially there may not be any symptoms. That is, the patient may not even feel that he has a certain problem. However, the situation changes with the years. The heart is working more actively to compensate for the lack of blood. As a result, the left ventricle slightly increases, and the heart itself becomes weaker. Here the insufficiency of the aortic valve also makes itself felt. Symptoms that may arise in this case:

• Constant fatigue, weakness in the whole body.
• The patient has shortness of breath. It increases during physical activity.
• Also there are arrhythmias, that is, disturbances of the heart rhythm.
• The patient may complain of an accelerated heartbeat.
• With pains, chest pain (angina pectoris) may occur.
• Very rarely patients also suffer from loss of consciousness.

If the patient is an acute failure, then all the symptoms appear suddenly, their strength is greater, they manifest themselves more vividly. In this case, patients often need urgent ambulance, up to the rescue of life.

On the degrees of insufficiency

Also has such a problem as aortic valve insufficiency, the degree of development. They differ in the length of the jet that is injected back into the ventricle through the poorly closed valves. Depending on this, they are divided into three: the first, the second and the third.

First degree

What is special about aortic valve failure? In this case, the jet does not exceed a length of 5 mm from the aortic leaflets. So, this problem can still be called insignificant. After all, blood collects under the very leaves, without causing any special problems. Insufficiency of the aortic valve of 1 degree does not cause a significant increase in the left ventricle, in this case it can be of full normal size.

Second degree

Insufficiency of the aortic valve of the 2nd degree is especially significant in that the length of the jet in this case increases to 10 mm. That is, blood "sprinkles" at a distance of about 10 mm from the valve flaps. In this case, the jet can reach the valves of the mitral valve, which significantly worsens the situation. Insufficiency of the aortic valve of the 2nd degree increases pulsation in the carotid artery and heart, the left ventricle increases. This is all easily seen on the echocardiogram.

Third degree

A grade 3 aortic valve is characterized by the fact that the blood is injected back to a distance that exceeds 10 mm. In this case, the jet crosses the mitral valve and can reach the top of the left ventricle. In this case, the boundaries of the heart increase by more than 2 cm, the ECG can "see" the left ventricular hypertrophy.

Insufficiency in children

Separately, I want to consider the insufficiency of the aortic valve in children. Will there be any differences between an adult and a child? So, the symptomatology will be slightly different. In this case, the children most often observed pallor of the skin, pulsation of the arteries in the limbs, may develop a symptom of Musset (the child will shake his head to the sides depending on the rhythm of the heartbeat). As for the treatment and diagnosis of the problem, the procedure for both children and adults will be the same.

Diagnostics

A preliminary diagnosis of "aortic valve failure" can be made by the doctor after listening to (auscultation) uncharacteristic noises in the heart (there will be an unusual diastolic noise). However, this is only an assumption. Then the doctor will ask about the symptoms that may indicate the presence of this problem, will collect a complete history. Further, the doctor will send the patient for additional studies that confirm or refute the previously formulated diagnosis.

• Palpation . In this case, a specialist can, by feeling, determine the trembling over the base of the heart. This is due to the release of a very large volume of blood. Also "observed" percussion, when the boundaries of the heart "go" to the left.
• ECG . This procedure makes it possible to determine the increase in the size of the left ventricle of the heart.
• Echocardiography . This procedure in two-dimensional mode reveals hypertrophy of the left ventricle. In one-dimensional - it is able to distinguish the fluttering of the mitral valve leaf due to the ingress of a jet into it.
• Dopplerography makes it possible to determine the degree of aortic valve insufficiency - shows the length of the jet of back-injected blood.
• X-ray . If the aortic valve is deficient, this procedure makes it possible to "see" the increase in heart size, the calcification of the valves.
• To determine the increase in intracardiac pressure, a procedure for catheterization of the heart cavities can be prescribed. In this case, physicians distinguish four degrees of aortic valve failure according to the volume of blood injected back. At the first degree it is approximately 15%, at the second - from 15 to 30%, at the third - from 30 to 50%, at the fourth - more than 50%.

If a patient is previously diagnosed with "aortic valve failure", the diagnosis of the problem will not necessarily be performed using all these methods. So, the doctor decides for himself what the patient needs at this stage. It should be noted that, in addition to the above diagnostic methods, coronary angiography is sometimes used, which can be prescribed for the same indications as for stenosis of the aortic aorta.

Treatment medication

If the patient is diagnosed with "aortic valve failure," the treatment will depend on the degree of the patient's illness. Thus, the urgency of the use of certain drugs or procedures is interrelated with the severity of the manifestation of various symptoms. If the form of the disease is chronic, therapeutic treatment is possible.

Medication that the patient may need:

1. Diuretics . The main goal of these drugs in this case is to remove excess fluid from the body, lower blood pressure.
2. Antibiotics . Can be appointed as a prophylaxis of infectious diseases in surgical or dental procedures.
3. Calcium channel blockers (mainly Nifedipine) are also prescribed, the main purpose of which is to reduce the leakage of blood. It should be noted that in some cases, the use of these drugs can be an excellent alternative to surgical intervention.
4. Other drugs, such as ACE inhibitors or angiotensin receptor blockers, may also be prescribed .

It should also be noted that patients with this problem, even if present in chronic form, should be registered with the doctor. They periodically have to visit a doctor. Radical measures in this case are not always shown.

Surgical intervention

If the disease occurs in acute form, there is a need for urgent surgical intervention. The earlier a person gets to a doctor, the higher the chance to stay alive. And although the mortality rate in this case is not great, delaying treatment to doctors can cost the patient even life.

Also, surgical intervention is indicated for patients who have been diagnosed with "aortic valve failure" for quite some time. If the patient has already developed symptoms, even if initially weakly, the left ventricle loses its contractility - these are all indications for surgical replacement of the aortic valve.

As a reference, it should be noted that today the surgical intervention basically ends positively and brings the desired result to the patient. The first similar operation was made in the distant 1960 by Dr. Harken, who prosthetized the aorta with a plastic ball and a metal cage. In the Soviet Union, such an operation was first carried out in 1964, successfully. Since that time, doctors have developed many techniques and techniques to make this surgical intervention as qualitative and effective as possible.

Survival of patients

If the patient has moderate or mild heart failure, 10-year survival is very high and accounts for almost 90% of all patients. If complaints start to appear, symptoms appear, the situation can deteriorate sharply. In this case, if you do not resort to surgery, a fatal outcome can occur approximately in 2-5 years, depending on the development of other diseases.

If the course of the disease is completely asymptomatic, the prognosis is maximally favorable. In this case, surgical intervention is required only in 4% of cases. In this case, complaints can arise in patients during the first five years - in 20% of patients, in seven years - in about 25% of patients. If the failure is acute, severe, a fatal outcome is possible in case of arrhythmia of the ventricles. If the operation is done in time, such a development of events can be avoided.

Prevention

Preventive measures to not acquire such a disease, no. In this case, diets or a certain lifestyle can not help. But patients who are at risk can save themselves. So, they regularly have to undergo examinations with the doctor, do the prescribed procedures. The schedule of the examination may be different, but you can not visit the treating doctor less than once a year.