Among the acquired heart defects, aortic stenosis is one of the most common: this pathology is fixed in every tenth person of 60 to 65 years, and men suffer it four times more often.
In general, stenosis is a narrowing of the aortic valve, because of which, at the time of contraction (systole) of the left ventricle, the flow of blood from it to the ascending part of the aorta becomes more difficult.
Types and causes of aortic stenosis
It is customary to distinguish between congenital malformation and acquired one. In the first case, the aorta has two or one valves (normal - three), which causes the aortic aperture to narrow, and the left ventricle has to work with a greater load.
Acquired pathology is provoked by rheumatic processes (up to 10% of cases), which are often accompanied by insufficiency or stenosis of the mitral valve. Young people get aortic stenosis because of rheumatism .
Symptoms of stenosis of the aortic valve may also appear against the background of endocarditis, in which the valves are joined and become rigid, narrowing the lumen.
In elderly people, atherosclerosis or deposition of calcium salts (calcinosis) is most often observed on the valve flaps, which also leads to narrowing of the lumen.
Symptoms of aortic stenosis
At the initial stages of the development of pathology, signs of stenosis are practically not manifested, and it is often detected accidentally during a planned examination of the heart. Even after the diagnosis, the symptoms can make you wait a few more years.
The patient is registered with a cardiologist and observed during the course of the disease. Over time, the narrowing of the aortic valve lumen leads to shortness of breath and increased fatigue, which is especially noticeable during physical activity. This is called a moderate stenosis of the aortic valve - the lumen area decreases to 1.6-1.2 cm2, while in a healthy person this value is 2.5-3.5 cm2.
At the second stage of development of pathology (expressed stenosis), the lumen size is noted to be no more than 0.7-1.2 cm2. During physical exertion, such patients complain of dizziness and stenocardia (pain behind the sternum), fainting is possible.
The following stages are a sharp and critical aortic stenosis, characterized by symptoms such as choking, cardiac asthma and even pulmonary edema. The lumen decreases to 0.5-0.7 cm2.
In the case when the stenosis is congenital, its signs first appear in the second or third decade of life, and the pathology develops more rapidly.
Treatment of aortic stenosis
To date, there is no specific treatment for this pathology, and in the early stages only monitor its development.
In the latter stages, when a narrowing of the aortic valve lumen delivers a person discomfort in the manner described above, a valve replacement operation is appropriate. It is quite complex and dangerous, especially for teenagers and old people. At the same time, progressive symptoms threaten the patient's life even more - with critical aortic stenosis live about 3 to 6 years.
An alternative to surgical replacement of the valve is balloon valvuloplasty. The procedure involves inserting into the valve opening a special miniature balloon, through which air is supplied. Thus, it is possible to widen the valve clearance, however, valvuloplasty is no less risky than conventional valve prosthetics.
Lifestyle
Patients with aortic stenosis are contraindicated in large loads. Heart failure, developing against the background of pathology, is treated traditionally, however, preparations of the group of vasodilators, as a rule, do not give an effect. From attacks of angina helps nitroglycerin, which should be worn with them.