Aortic valve insufficiency

Aortic valve insufficiency is a common pathology. Aortic insufficiency is an acquired heart disease characterized by abnormalities in the functioning of the aortic valve. The disease is diagnosed in both the elderly and the young, as well as children.

Treatment of aortic insufficiency involves the use of two methods: drug therapy and surgery. The choice depends on the degree of the disease and its symptomatic severity.

Basic treatments for aortic valve insufficiency

When blood enters the aorta, the valve leaflets may close completely, causing some blood to flow back into the ventricle. He makes additional contractions to push her back, but the blood comes back again. The left ventricle constantly experiences additional load and pressure from excess fluid. Gradually it increases in volume.

Aortic valve insufficiency has 4 degrees. The first two usually do not require treatment, with the third and fourth, conservative (drug) or surgical treatment may be indicated.

Aortic valve insufficiency: conservative treatment

Drug treatment is aimed at alleviating severe symptoms in patients and preventing acute heart failure, which is one of the complications of aortic insufficiency.

It is shown in such cases:

• for long-term therapy of patients with severe aortic insufficiency, if for some reason surgical treatment is not recommended for them;
• for short-term effects in order to improve the hemodynamic state of people who have pronounced symptoms of heart and aortic insufficiency;
• for the treatment of patients in whom symptoms are not expressed, but studies confirm an increase in the left ventricle;
• for long-term therapy of patients with severe symptoms with normal, mild or moderate degree of ventricular dysfunction who qualify for aortic valve transplantation.

Depending on how severe aortic insufficiency is, a complex of drugs is prescribed, combining the following groups of drugs:

• vasodilators (ACE inhibitors, hydralazine). They slow down the development of pathology. They are prescribed in the presence of contraindications to surgical treatment;
• cardiac glycosides of cardiotonic and antiarrhythmic action;
• nitrates, beta-blockers are indicated in cases where the aortic root is significantly dilated;
• antiplatelet agents are prescribed to patients with thromboembolic complications.

Medicines are recommended to be used to treat the disease, starting from the second degree.

The initial form of the disorder requires compliance with a special regimen: patients are advised to limit vigorous physical activity and avoid nervous tension. It is necessary to constantly be under the supervision of a cardiologist.

Aortic insufficiency: features of surgical treatment

There are two main methods of surgical intervention:

1. Prosthetics is the installation of a new valve that ensures the normal functioning of the heart. Artificial materials (silicone, metal) and biomaterials (donor valves or own from the pulmonary artery) are used as prostheses. This type of surgical treatment is the most common and radical, after which a long recovery period is required.
2. Valvuloplasty is the elimination of valve defects (excision or suturing). The operation does not require an opening of the chest and general anesthesia. In the process of surgical intervention, there is a mechanical increase in the lumen in the region of the valve leaflets. For this, a special balloon is used. This method is popular in the treatment of newborns.

The choice of material for a valve prosthesis depends on age. Bioprostheses made from tissues of pigs, cows or humans wear out within 10-15 years. After this period, the patient may need a second operation. The mechanical valve is installed for life, but the person must constantly take blood-thinning drugs (Warfarin, Coumadin).

The choice of the valve must be agreed with the doctor, taking into account all the necessary postoperative complications and a list of recommendations for recovery.

Chronic aortic insufficiency: features of therapy

The chronic form of the disease is characterized by a slow process of dilatation (development of dysfunction) of the left ventricle. It may be asymptomatic or disturb the patient with periodic shortness of breath and angina pectoris. Sometimes patients complain of tingling pain in the region of the heart.

To do this, conduct a set of studies aimed at studying the state of the heart muscle. Depending on the results, one of the types of therapy may be prescribed: medical or surgical treatment.

In the initial stages, with minor pathologies, medicines are not prescribed, but are recommended:

• adhere to a certain diet;
• observe the mode of physical activity;
• do not forget about the periods of sleep and rest.

Additionally, diuretics, calcium channel blockers may be prescribed. An important aspect of the treatment of chronic aortic insufficiency is the observance of preventive measures: taking antibiotics before procedures and manipulations (for example, dental and surgical) in order to avoid the entry of bacteria into the body and prevent the further development of infectious diseases.

Chronic aortic insufficiency, subject to therapeutic recommendations, is normally tolerated by patients. Survival among patients with this diagnosis is about 75% over 5 years and 50% over 10 years. The prognosis may worsen as symptoms develop.

Aortic valve insufficiency: acute treatment

This form is manifested by complex pathologies: arterial hypotension, pulmonary edema. It quickly leads to complications in the work of the cardiovascular system.

Acute aortic insufficiency is manifested by the following symptoms:

• weakness
• severe shortness of breath
• loss of consciousness.

Additionally diagnosed:

• cyanosis or pallor of the skin,
• increased heart rate,
• a sharp drop in blood pressure.

Medical treatment is ineffective. It is used in the period of preparation for surgery to stabilize the patient's condition. Vasodilators are prescribed to reduce the load on the left ventricle and diastolic pressure.

The appointment of additional drugs depends on the cause and degree of development of acute aortic insufficiency:

1. If it occurs as a result of infective endocarditis, antimicrobial therapy is started after receiving the results of the analysis of bacterial culture.
2. If the cause is trauma, surgery is prescribed immediately, medications are used to increase cardiac output.

Among patients diagnosed with acute aortic insufficiency, the percentage of deaths is high, this pathology in most cases requires immediate surgical intervention. Before the operation, all people over 50 years of age undergo coronary angiography, a study aimed at diagnosing the state of the cardiovascular system. It is carried out with the help of a contrast agent. It is injected into the coronary arteries through the femoral or radial artery.

Treatment of aortic insufficiency in children

Aortic valve insufficiency can occur at any age, and in children too.

This violation may be:

• congenital;
• arise as a result of an infectious or autoimmune disease;
• appear after a mechanical injury to the heart.

It is impossible to treat aortic valve insufficiency even in the first degree in children on their own.

Parents should do their best to comply with all medical recommendations. If there are signs of acute heart failure, you need to urgently call an ambulance.

If there are no symptoms and the pathology was detected by chance during a routine examination, treatment is not prescribed. Such children are put on a permanent record with a cardiologist to monitor the condition of the heart muscle.

Among these signs:

• arrhythmia,
• fatigue,
• weakness,
• tachycardia,
• pain in the region of the heart,
• loss of consciousness,
• complaints of children about feeling unwell after physical exertion.

In severe cases, surgery may be indicated. For the treatment of children, balloon valvuloplasty is most often performed. This type of operation is indicated even for newborns.

The prognosis of the effectiveness of treatment depends on several factors, the main among which is timely diagnosis. Any alarming symptoms and discomfort in the region of the heart, shortness of breath, fatigue in children and adults should be a reason to contact a cardiologist. In the initial stages, with the help of modern medicines, you can significantly slow down the development of the disease and avoid serious complications. After confirming the diagnosis of "aortic insufficiency", you need to constantly be registered with a cardiologist and undergo a preventive examination several times a year in order to identify complications in time and, if necessary, correct treatment.