Aortic stenosis – causes, first symptoms, diagnosis and treatment

There are a number of diseases that are congenital or acquired. One of the acquired heart defects is aortic stenosis. This diagnosis is made by approximately 2-7% of the population at the age of sixty-five, more often than men than women.

Aortic stenosis is a heart defect, which is represented by a narrowing of the aorta and is a consequence of pathological changes in the aortic valve and periclapse systems. Such damage complicates the outflow of blood and leads to a significant difference in pressure in the left ventricle and aorta.

Violation of the blood flow is caused by an increase in the load on the left ventricle, since the passage of the aortic valve has narrowed. In systole, the blood does not completely manage to exit the ventricle into the aorta and some part of it remains in it.

Naturally, in this case, the ventricle enlarges, hypertrophies, and its contractility decreases. In violation of the reduction function, blood begins to stagnate, shortness of breath appears.

There is a classification that considers or, more precisely, studies this disease according to all possible principles or aspects. Particular attention is paid to the origin of aortic stenosis. It can be congenital when there is a malformation that occurs even in the womb, and acquired.

The following types of this disease characterize it at the location (localization):

  • valve,
  • supravalvular or subvalvular.

Paying attention to the severity of this ailment, allocate:

  • minor,
  • moderate,
  • severe type of this disease.

Depending on the nature of the circulatory disturbance, compensated and decompensated aortic stenosis are distinguished.

Hemodynamic changes

The clinical picture of stenosis of the aortic orifice is due to the characteristic hemodynamic disturbances arising from this defect. With aortic stenosis, the flow of blood from the left ventricle to the aorta is impeded, as a result of which the systolic pressure gradient between the cavity of the left ventricle and the aorta increases significantly. It usually exceeds 20 mmHg. Art., and sometimes reaches 100 mm RT. Art. and more.

Due to this pressure load, the function of the left ventricle increases and its hypertrophy occurs, which depends on the degree of narrowing of the aortic orifice. So, if the normal area of ​​the aortic orifice is about 3 cm?, Then halving it causes a pronounced hemodynamic disturbance.

Especially severe violations occur when the hole area is reduced to 0,5 cm ?. The final diastolic pressure may remain normal or slightly increase (up to 10-12 mm Hg) due to impaired relaxation of the left ventricle, which is associated with severe hypertrophy.

Due to the large compensatory capabilities of the hypertrophied left ventricle, cardiac output remains normal for a long time, although it increases less when loaded, than in healthy individuals. When symptoms of decompensation appear, a more pronounced increase in the final diastolic pressure and dilatation of the left ventricle are observed.

    Concentric hypertrophy of the left ventricle.

Narrowing of the aortic orifice and obstruction of the outflow of blood from the left ventricle (ie the appearance of the so-called “third barrier” in the bloodstream) leads to a significant increase in the systolic pressure gradient between the left ventricle and the aorta, which can reach 50 mmHg. Art. and more.

As a result, systolic pressure in the left ventricle and intramyocardial tension sharply increase. A significant and long-term increase in afterload leads to the development of severe concentric LV myocardial hypertrophy. In this case, the ventricular cavity does not increase in size.

Over a long period of time (up to 15–20 years), the defect remains fully compensated: despite a high pressure gradient, hypertrophied LV provides normal cardiac output and blood pressure (at least at rest). Bradycardia and compensatory lengthening of LV systole, characteristic of aortic stenosis, also contribute to this.

Despite the persistence of normal myocardial contractility and LV systolic function for a long time, severe myocardial hypertrophy is accompanied by LV diastolic dysfunction, which occurs primarily due to impaired compliance of the ventricular muscle mass and inhibition of the process of active LV myocardial relaxation.

Violation of the diastolic filling of the ventricle is accompanied by an increase in blood pressure in the left ventricle and filling pressure. As a result, there is a redistribution of diastolic blood flow in favor of the drug, which enhances its contractions. The contribution of the atria to the formation of stroke volume increases significantly.

This is essentially the second important compensatory mechanism for maintaining normal cardiac output. If for some reason the atrium “falls out” of the contraction (for example, with atrial fibrillation), there is a sharp deterioration in the condition of patients with aortic stenosis.

On the other hand, a violation of the LV diastolic function is naturally accompanied by an increase in pressure in the LP, as well as in the veins of the pulmonary circulation.

Under these conditions, the effect of any adverse factors (physical activity, elevation of blood pressure in patients with concomitant hypertension, the occurrence of atrial fibrillation, etc.) can lead to a noticeable increase in congestion in the lungs and the appearance of clinical signs of left ventricular failure, in this case, its diastolic form.

Fixed stroke volume.

Despite the fact that the cardiac output in patients with stenosis of the aortic orifice remains unchanged for a long time, its growth during physical activity is noticeably reduced. This is mainly due to the existence of a “third barrier” on the path of blood flow – obstruction of the aortic valve ring.

The inability of the left ventricle to adequately increase the VO during exercise (fixed stroke volume) explains the frequent appearance in patients with aortic stenosis of signs of impaired brain perfusion (dizziness, syncope), characteristic of these patients even in the stage of defective compensation.

Perfusion of peripheral organs and tissues is impaired by vasoconstrictor vascular reactions, including due to activation of CAS, RAAS and vasoconstrictor endothelial factors.

Disorders of coronary perfusion.

Violations of coronary perfusion with stenosis of the mouth of the aorta occur quite early. They are due to the action of the following factors:

  • severe LV myocardial hypertrophy and the relative predominance of muscle mass over the number of capillaries (relative coronary insufficiency);
  • an increase in blood pressure in hypertrophied LV and, accordingly, a decrease in the diastolic gradient between the aorta and the ventricle, under the influence of which coronary blood flow occurs during diastole;
  • compression of subendocardial vessels with hypertrophied LV myocardium.

Thus, even in the absence of concomitant atherosclerotic narrowing of the coronary arteries in patients with aortic stenosis, signs of coronary insufficiency naturally occur, and long before the development of cardiac decompensation.

Heart decompensation usually develops in the late stages of the disease, when the contractility of the hypertrophied LV myocardium decreases, the magnitude of the PV and UO decreases, there is a significant expansion of the LV (myogenic dilatation) and a rapid increase in the end-diastolic pressure in it, i.e. LV systolic dysfunction occurs.

At the same time, pressure in the LP and veins of the pulmonary circulation increases and a picture of left ventricular failure develops.

Sometimes in patients with severe left ventricular failure with significant expansion of the left ventricle and the fibrous ring of the bicuspid valve, relative mitral valve insufficiency develops (“mitralization” of the aortic defect), which further exacerbates the signs of stagnation of blood in the lungs.

Finally, if within 2–3 years from the occurrence of left ventricular failure there is no death, high pressure in the pulmonary artery can lead to the development of compensatory pancreatic hypertrophy, and then to its insufficiency, although these changes are generally not typical for patients aortic stenosis.

They can appear, as a rule, at the final stage of the development of the disease, especially with the “mitralization” of aortic heart disease.

Degrees of aortic stenosis

5 stages of aortic stenosis are distinguished depending on the degree of hemodynamic disturbances.

    Stage 1 – full compensation.

Pathology does not manifest itself in any way, but is detected by chance during the examination. Aortic stenosis is detected only auscultatory, the degree of narrowing of the aortic orifice is small. Patients require dynamic monitoring by a cardiologist; surgical treatment is not indicated.

Stage 2 – latent heart failure.

It is characterized by the following complaints:

  • fatigue;
  • shortness of breath with moderate physical exertion;
  • weakness;
  • palpitation;
  • dizziness.

Signs of aortic stenosis are determined by ECG and radiography, a pressure gradient in the range of 36–65 mm RT. Art., which becomes an indication for surgical correction of the defect.
Stage 3 – relative coronary insufficiency.

Typically increased dyspnea, the occurrence of angina pectoris, fainting. The systolic pressure gradient exceeds 65 mm Hg. Art. Surgical treatment of aortic stenosis at this stage is possible.

Stage 4 – severe heart failure.

Disturbing shortness of breath at rest, nightly attacks of cardiac asthma. Pain in the region of the heart appears at rest. Surgical correction of a defect is, as a rule, excluded; in some patients, cardiac surgery is potentially possible, but with less effect.

Stage 5 – terminal.

Heart failure is steadily progressing, shortness of breath and edematous syndrome are pronounced. Medication helps to achieve short-term improvement; surgical correction of aortic stenosis is contraindicated.

Causes of pathology

Before determining the causes of aortic stenosis, it should be noted that the pathology can be congenital or acquired. A congenital species makes up about 10% of all cases of the disease and is the result of anomalies in the development of the aortic valve and its various defects. The norm is when the valve has 3 wings.

They regulate the flow of blood from the left ventricle to the aorta. With congenital pathology, this element will consist of two or one leaf. A two- or single-leaf valve differs from normal by a narrower lumen, which prevents optimal flow of blood. This causes overload of the left ventricle.

In the vast majority of cases, aortic stenosis is an acquired heart disease. Such a pathology in adults begins to occur after they reach 60 years of age. Specialists identify a number of factors under the influence of which the risk of developing aortic stenosis increases.

These include smoking, high blood cholesterol, and hypertension. Acquired aortic valve stenosis develops as a result of the following reasons:

  • rheumatism disease;
  • heredity;
  • degenerative processes in the structure of the valve;
  • aortic calcification;
  • atherosclerosis of the aorta;
  • systemic lupus erythematosus;
  • severe renal failure;
  • endocarditis is infectious.

In patients with rheumatism, valve flaps are affected, which causes them to contract. As a result of this process, they become dense and lose flexibility, which causes a narrowing of the holes in the valve. Deposition of salts on the aortic valve or calcification often results in reduced leaflet mobility.

As a result of this, narrowing also occurs. Such pathological transformations occur with infectious endocarditis. In some cases, degenerative processes observed in the valve itself lead to aortic stenosis. They begin to appear in people after 60 years.

Since this reason is associated with age-related changes and deterioration of the valve, the disease is called idiopathic aortic stenosis. Degenerative processes that cause stenosis also occur with atherosclerosis of the aorta itself. In this case, sclerosis and violation of the mobility of the valves occurs.

With aortic stenosis, an obstructive process in the heart is observed – difficulty in moving blood flow to the aorta from the left ventricle.

Signs and symptoms

At the stage of absolute compensation of stenosis of the aortic orifice, patients do not experience significant discomfort. Symptoms of heart disease appear when the opening of the aortic valve is narrowed to 50% and manifests itself:

  • shortness of breath, which first appears during physical activity, and then at rest or during sleep;
  • syncopal conditions: dizziness, nausea and fainting that occur during exercise or a quick change in body position due to transient insufficiency of cerebral circulation;
  • fatigue and general weakness;
  • attacks of cardiac asthma and pulmonary edema (in severe cases);
  • angina attacks.

A visual examination of the patient determines:

  • sharp pallor;
  • acrocyanosis (in the later stages).

Subsequently, the patient develops pulmonary hypertension and the functioning of the mitral valve may be impaired, which leads to the development of right ventricular failure, which is manifested by the following symptoms:

  • swelling of the extremities;
  • heaviness and discomfort in the right hypochondrium;
  • an increase in the size of the liver;
  • ascites.

When auscultation (listening) of the heart and lungs are determined:

  • gross systolic murmur in the aortic zone;
  • changes in II and I tone (more often they become weakened);
  • moist wheezing in the lungs (at the stage of development of left ventricular failure).

Pathology in children

In newborns and preschool children, this pathology sometimes proceeds without symptoms, but as they grow, the symptoms of stenosis become pronounced. An increase in the size of the heart and, accordingly, the volume of circulating blood occurs, and the narrow lumen in the aortic valve remains unchanged.

Narrowing of the aortic valve in newborns occurs due to abnormal development of the valves in the period of intrauterine development, which fuse together or there is no separation into 3 separate valves. You can see such a pathology in the fetus already at 6 months of pregnancy using echocardiography.

Sometimes stenosis manifests itself in the first days after birth, if the opening of the aortic orifice is less than 0,5 cm. In 30% of cases, the condition worsens sharply by 5-6 months. But in most patients, symptoms of aortic stenosis occur gradually over several decades.

Such a diagnosis is mandatory, because immediately after birth the child develops critical stenosis. The danger of the condition is that the left ventricle with aortic stenosis works with an excessively high load. If a pathology is detected on time, an operation is performed after the birth of the baby and an adverse outcome is prevented.

Critical stenosis is determined when the lumen in the aortic valve is less than 0,5 cm. Non-critical stenosis causes a deterioration in the condition of the baby during the first year of life, but within a few months after birth, the baby feels satisfactory.

In this case, insufficient weight gain and tachycardia with shortness of breath will be noted. If the parents suspect signs of malaise in the child, you need to contact a pediatrician. 70% of children with this congenital heart disease feel normal.

Guess about stenosis of the aortic orifice of the newborn by the following signs:

  • a sharp deterioration in the condition of the baby in the first 3 days after birth;
  • frequent spitting up;
  • the baby becomes lethargic;
  • lack of appetite;
  • weight loss;
  • rapid breathing over 20 times per minute;
  • the skin becomes bluish.

In older children, the situation is not as bad as in newborns. The doctor monitors the development of the disease in dynamics and selects the appropriate correction method. It is impossible to ignore the obvious signs of the disease, treatment is required, since a fatal outcome is possible. There are 3 options for the development of pathology:

  • valve flaps are stuck together and separation is required;
  • valve flaps are changed so that a complete replacement is required;
  • the diameter of the valve hole is so small that it is not able to pass through a device to replace part of the organ.

It is important to follow the doctor’s recommendations and be examined on time. If there is no need for urgent surgery, then surgery is done after 18 years, when the growth period ends. In this case, an artificial valve is installed that does not wear out and does not require replacement.

Diagnostics

Diagnosis of aortic stenosis is as follows: determining the cause of stenosis, assessing its severity and function of the left ventricle. It is important to identify the pathology of other heart valves, as well as concomitant systemic diseases. Diagnostic techniques should be adequately used, especially those requiring surgical intervention.

Congenital aortic stenosis, as a rule, does not affect the development of the child. Therefore, when examining the characteristic features of the physique, they are not revealed. Some pallor of the skin is noteworthy. In young people, it is possible to diagnose a cardiac hump.

This is a deformation of the chest, formed as a result of exposure to a significantly enlarged heart. The palpation of the pulse and the heart region, with the detection of noise, often provides the experienced clinician with the key to diagnosing a particular heart pathology.

The features of the pulse wave, palpable on the peripheral vessels, is a small filling of the pulse. Palpation of the heart region provides the doctor with a symptom of “systolic trembling” as a specific symptom of severe aortic stenosis. It is also possible to determine the presence of hypertrophy of the heart muscle.

Auscultation or listening allows you to get a certain idea of ​​the heart problems, the tones and noise created by it. A different combination of attenuation and migration of systolic murmur comes to light. Perhaps the appearance of a third tone or systolic murmur.

The auscultatory picture of aortic murmurs differs, depending on its origin and severity. The variability of blood pressure indicators in patients with pathology “stenosis of the aortic orifice” is as follows. In the case of isolation of the pathology, there is a tendency to hypotension and the systolic pressure figures are usually reduced to 90-100 mm Hg.

It is worth noting that in 10% of cases there is a tendency to hypertension. Venous pressure changes little, and is subject to increase only at the stage of heart failure. Among the many methods for diagnosing heart disease and aortic defects, in particular, some deserve the most attention.

Due to the fact that they are effective and affordable in the diagnosis of pathology. Conventionally, diagnostics can be divided into methods that do not require intervention (without violating the integrity of the tissues) and invasive manipulations. We list them:

    Electrocardiography is the gold standard in the diagnosis of many diseases of the cardiovascular system.

But, unfortunately, with aortic defects, specific ECG changes cannot be found.

Signs of left ventricular hypertrophy, a change in the electrical axis of the heart, and in the later stages, signs of mitral regurgitation are revealed. As well as cardiac arrhythmias according to the type of atrial fibrillation.

X-ray examination. It makes it possible to determine the size of the heart and large vessels.

Over the years of observation, clinicians have found that one or another pathology that causes changes in the contours of the heart leads to characteristic radiological patterns.

This means that the configuration of the ratios for a particular vice has its own silhouette in the picture. Accordingly, with aortic stenosis, the heart will have an “aortic configuration.” Unfortunately, the study helps to establish only a pronounced degree of stenosis.

Ultrasound examination of the heart or echocardiography (echocardiography).

It makes it possible to establish a particular heart defect and determine the structure of the valve, the nature of its movements, as well as the area of ​​the aortic orifice.

The wall thickness of various parts of the heart and the condition of large vessels are also evaluated. It is possible to visualize calcium deposits on valve flaps.

Doppler echocardiography is one of the varieties of ultrasound diagnostics that allows you to evaluate the dynamic parameters of the investigated environment.

It can measure pressure gradients between the ventricle and the aorta and reveal even a slight degree of aortic stenosis.

Also determine the reverse flow of blood from the aorta in the ventricle and the presence of its residual amount in the left ventricle, after systole.

Cardiac catheterization is an invasive procedure, the essence of which is the introduction of a probe through a large vein.

This tool is sent to the heart, for further study of the state of its valves and the degree of narrowing of the coronary arteries.

It also allows you to measure the pressure gradient in different departments. This manipulation is carried out before surgical treatment of heart valve pathology. Less commonly, coronarography, ventriculography, and aortography are used during diagnostic use.

Treatment of aortic stenosis

Treatment of aortic stenosis becomes necessary with an increase in threatening symptoms, which indicates the further development of the disease, which becomes life threatening. The treatment of the disease has two main goals:

  • prevention of heart failure and, as a consequence, the death of the patient;
  • a decrease in the severity of the symptoms of the disease.

Methods of treating aortic valve stenosis are conventionally divided into medical and surgical. Both congenital and acquired aortic stenosis are treated, starting from the severity of the development of the disease and the intensity of its course.

Slow development of stenosis does not require immediate surgical intervention, unlike rapidly developing. With the acquired form of the disease, treatment must be carried out in parallel with the therapy of the disease, which caused the occurrence of aortic stenosis.

Taking medications is aimed at slowing the development of heart failure, preventing coronary heart disease, normalizing blood pressure and eliminating arrhythmias.

There are contraindications for open heart surgery for the elderly, adolescents, as well as people with poor health. The last two categories can be assigned an alternative procedure in the form of balloon valvuloplasty, during which a thin balloon is inserted into the aortic valve to inflate (expand) it.

This is a much safer and more reliable procedure compared to open heart surgery. The use of this type of surgery to treat people of advanced age is considered ineffective, since due to age-related changes in their body, the improvement will be only short-term.

Percutaneous valve replacement is also practiced, but the main method for treating aortic stenosis is valve prosthetics, during which the valve is replaced with a mechanical analog or xenogenic bioprosthesis. Such a patient is prescribed a lifetime intake of anticoagulants.

Transplantation of the pulmonary valve into the aortic position is performed in pediatric cardiac surgery. They can also resort to plastic subvalvular or supravalvular stenosis. Aortic stenosis in women in the presence of complications can be the reason for abortion, therefore, special attention should be paid to hemodynamics.

Complicating the symptoms poses a serious risk to the patient’s life; in severe form, the disease allows you to live only a few years.

Medication

If surgical intervention is impossible or in the absence of indications, medication is prescribed. In addition, drug therapy is indicated for patients who have undergone valve replacement surgery. Conservative treatment of aortic stenosis consists in the following therapeutic measures:

  • stabilization of blood pressure;
  • slowing down the pathological process;
  • elimination of cardiac arrhythmias.

The following groups of drugs are used:

  • beta-blockers;
  • nitrates;
  • diuretics to reduce the risk of heart failure;
  • angiotensin converting enzyme inhibitors;
  • cardiac glycos >

Methods of surgical treatment of aortic stenosis are the replacement of a damaged valve by surgery. Indications, contraindications for surgery are determined individually by the doctor. Indications:

  • the area of ​​the aortic opening is less than 1 cmx2;
  • infant congenital aortic stenosis;
  • critical stenosis during pregnancy;
  • left ventricular fractional ejection less than 50%.
  • advanced age (70 years and above);
  • 5 degree of the disease;
  • severe concomitant disease.

The following surgical methods are used:

  • aortic valve replacement;
  • balloon valvuloplasty;
  • percutaneous valve replacement.

Aortic valve replacement

Prosthetics is a common type of surgical treatment for aortic stenosis. In the form of a valve prosthesis, both artificial materials (silicone, metal) and biomaterials — a valve from one’s own pulmonary artery or donor valve — are used. Indications for surgery:

  • the area of ​​the aortic opening is less than 1 cm;
  • severe stenosis of the aortic orifice with fainting and signs of heart failure;
  • narrowing of the aortic valve is accompanied by problems with other heart valves or coronary vessels;
  • ventricular arrhythmia;
  • only 50% of blood is ejected from the left ventricle;
  • reduced blood pressure in the arteries during tests with physical activity.

After such an operation, the appointment of anticoagulants that thin the blood is often required. This is due to the fact that as a result of the operation, the risk of thrombosis increases. The donor prosthesis is sutured temporarily, the service life is 5 years. Then perform a second operation.

  • eliminates the symptoms of the disease;
  • improves the condition of the heart and blood vessels;
  • the operation is effective even in old age.

In those cases when it is impossible to conduct an open intervention, percutaneous valve replacement is performed. Using a catheter, a specially packaged artificial valve is placed in the aorta, which opens and tightly presses against the walls of the vessel.

  • requires opening the chest;
  • long recovery period;
  • repeated operation is possible;
  • do not perform in severe chronic diseases of the kidneys, lungs and liver and irreversible changes in the heart.

Balloon Valvuloplasty and Percutaneous Valve Replacement

Balloon valvuloplasty is used to treat children. It also becomes a preparation for prosthetics. For adult patients, this technique is carried out in exceptional cases, since the valve flaps become fragile with age and are destroyed as a result of the intervention.

Indications for surgery:

  • congenital aortic stenosis in children – a single-leaf or bicuspid valve;
  • in adults, before valve transplant surgery, if the hole size is less than 1 cm;
  • during pregnancy;
  • as the only possible treatment in people with severe concomitant diseases for whom valve replacement surgery is contraindicated.

The operation consists in mechanically increasing the clearance in the area of ​​the valve flaps using a special balloon.

The operation is performed without penetration into the chest cavity. A special can is introduced through the femoral artery, which expands the narrowed lumen of the aorta.

Manipulations are carried out under the control of radiography. Advantages of the method:

  • low invasiveness;
  • well tolerated;
  • The recovery period takes from a few days to two weeks.

With incorrect manipulation, aortic stenosis is complicated by valve insufficiency, in which part of the blood returns back to the cavity of the left ventricle. In some cases, the procedure leads to embolism of the vessels of the brain and the development of a stroke.

Very rarely, surgery is complicated by infection, heart damage, or heart attack. The disadvantages of the method:

  • adult performance 50%;
  • the likelihood of the valve opening narrowing again;
  • can not be done if calcium deposits are on the valves;
  • do not perform in the presence of blood clots or inflammation.

Sometimes this method causes the following complications:

  • valve insufficiency;
  • cerebrovascular embolism;
  • heart attack;
  • stroke.

Percutaneous valve replacement is carried out on the same principle as balloon valvuloplasty. The difference is that in this case, an artificial valve is installed that opens after insertion through the artery. This method of replacing the aortic valve is minimally traumatic, but there are contraindications.

Diet for aortic stenosis

Effective treatment of aortic stenosis is impossible without following an appropriate diet. The following products are recommended:

  • sweet tea;
  • fat-free varieties of meat and fish;
  • dairy products;
  • fruits, vegetables, juices;
  • porridge.

It is required to exclude the consumption of the following products:

  • coffee;
  • spicy, salty, smoked, fatty;
  • fast food;
  • gas drinks and desserts containing dyes;
  • alcohol.

In addition, the patient needs a complex of vitamins. Excess weight is required to reduce.

Treatment with folk remedies

The use of traditional medicine is possible only after consultation with a doctor. The following methods are used:

    Grind in a meat grinder 4 kg of roots and celery leaves, 400 g of garlic horseradish roots, 8 lemons with a peel.

Place the resulting potion in an enameled or glass container for 12 hours in a warm place (+ 30 ° C), then in the refrigerator for three days.

After this time, squeeze the juice from the mixture and take one dessert spoon three times a day before meals for 15 minutes.

Preliminarily chopped, mix thoroughly 30 g of meadowsweet, 20 g of leaves of kidney tea and motherwort five-bladed, 15 g of leaves of warty birch and flowers of hawthorn, 10 g of peppermint leaves.

Pour 300 ml of boiling water a teaspoon of the collection, leave for an hour to infuse and take half a glass before meals three times a day.

Mix 20 grams of the leaves of the large plantain and grass of the meadowsweet, 15 grams of the leaves of the nettle and Astragalus woolly, 10 grams of the flowers of the mountain arnica, the herbs of the lemon balm, and the yarrow.

Pour a teaspoon of the mixture with 200 ml of boiling water and take 50-70 ml per day three times for one to three months.

Pour a teaspoon of the collection with a glass of boiling water, leave to infuse for one hour and drink two or three sips of the entire portion throughout the day.

The following collection is well established in the treatment of aortic stenosis. Grind and mix 5 parts of grass of sousenitsa marshmallow, 4 parts of grass of motherwort five-bladed, 3 parts of grass of horsetail, 2 parts of leaves of coltsfoot, seeds of fragrant dill, grass of yarrow and flowers of hawthorn.

Brew for an hour a teaspoon of the mixture with a glass of boiling water, filter and drink 100 ml twice a day for 2 months.

Complications

Complications without surgery are:

  1. Progression of chronic heart failure to terminal death.
  2. Acute left ventricular failure (pulmonary edema).
  3. Fatal arrhythmias (ventricular fibrillation, ventricular tachycardia).
  4. Thromboembolic complications in the event of atrial fibrillation.

Complications after surgery are bleeding and suppuration of the postoperative wound, the prevention of which is careful hemostasis (cauterization of small and medium vessels in the wound) during surgery, as well as regular dressings in the early postoperative period.

In the long term, acute or repeated bacendocarditis with valve damage and restenosis (repeated fusion of valve flaps) may develop. Prevention is antibiotic therapy.

Prevention of disease

Congenital aortic stenosis cannot be prevented. Prevention of the acquired form of this ailment should begin with the identification of concomitant pathologies and the observance of the precautions common to all cardiovascular diseases:

  • elimination of excessive physical exertion;
  • limitation of salt and liquids;
  • exclusion from the menu of fried and fatty foods;
  • smoking cessation and alcohol abuse;
  • regular intake of medications prescribed by a doctor;
  • carrying out the necessary diagnostic measures;
  • going to the doctor if warning signs appear.

In addition, there are several rules that patients with aortic stenosis must follow:

  • regular visit to the cardiologist;
  • conducting echocardiography every six months to a year;
  • prophylactic use of antibiotics before performing invasive procedures.

A separate case is pregnancy. Special control over the hemodynamics of a woman “in an interesting position.” The severe course of the disease or the appearance of ever new signs of heart failure can lead to termination of pregnancy (for medical reasons).

“Recognizing” the symptoms of aortic stenosis is the cornerstone for doctors and patients themselves. The appearance of new symptoms accelerates the onslaught of the disease, aggravating the condition of patients, and significantly reduces the duration and quality of life.

Therefore, even a half hint of the first symptom should be a signal for immediate treatment and mandatory prevention. The concept of “the right to surrender to an illness” for a person armed with the necessary knowledge should not exist.

Lifestyle with aortic valve stenosis

Currently, heart disease, including aortic valve stenosis, is not a sentence. People with this diagnosis live quietly, play sports, bear and give birth to healthy children.

Nevertheless, you should not forget about heart pathology, and you should lead a certain lifestyle, the main recommendations for which include:

  1. Compliance with diet – the exception of fatty and fried foods; rejection of bad habits; eating a large number of fruits, vegetables, cereals, dairy products; restriction of spices, coffee, chocolate, fatty meats and poultry;
  2. Adequate physical activity – walking, hiking in the forest, inactive swimming, skiing (all by agreement with the attending physician).

Pregnancy for women with aortic stenosis is not contraindicated if stenosis is not critical and severe circulatory failure develops. Termination of pregnancy is indicated only when the woman has a deterioration.

Disability is determined in the presence of circulatory failure 2B – 3 stages. After surgery, physical activity for the rehabilitation period should be excluded (1-2 months or more, depending on the state of the heart).

Children after surgery should not attend educational institutions for the period recommended by the doctor, and also avoid crowded places to prevent respiratory infections, which can dramatically worsen the condition of the child.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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