Regurgitation on the aortic valve in a child and an adult

Grade 1 aortic valve regurgitation is a pathological process in which circulating blood that has entered the aorta returns back to the heart. Most often, this condition occurs due to aortic insufficiency, which, in turn, is considered a consequence of incomplete adjacency (closing) of the aortic valve.

The main types of aortic insufficiency

This type of pathology is usually classified according to the volume of blood flow that goes from the aorta back to the heart.

There are 4 degrees of the disease:

1. The blood stream in no way overcomes the limits of the main outflow tract located in the left ventricle.
2. A stream of blood can even spread to the anterior leaflet of the mitral valve.
3. Blood begins to reach the papillary muscles themselves.
4. The stream of blood reaches the walls of the left ventricle.

Aortic valve insufficiency is divided into acute and chronic.

In the acute form, problems with hemodynamics quickly appear. If a person is not provided with proper first aid in time, then such a condition may well lead to the occurrence of cardiogenic shock.

The chronic form, as a rule, is characterized by the absence of any obvious symptoms of the disease. Since, over time, stagnation of blood forms in the pulmonary circulation, the left ventricular region begins to suffer. There is a lack of it. There is a decrease in diastolic blood pressure (blood pressure). The defeat of the main coronary arteries begins. Left ventricular contractility is significantly reduced.

Reasons for the development of the disease

The chronic form of insufficiency can develop due to several factors.

Dysfunction of the aortic valve itself:

• rheumatic disease;
• atherosclerosis;
• inflammation of the inner lining of the heart of bacterial origin;
• autoimmune diseases, especially lupus erythematosus;

• chest injury;
• diseases of the gastrointestinal tract (gastrointestinal tract), especially Crohn's disease;
• an allergic reaction to drugs that leads to severe valve damage;
• valve prosthesis wear.

Damage to the ascending branch and root of the aorta:

• in older patients, an increase in the aortic root is often observed;
• inflammation of the aortic wall, which most often occurs as a complication of syphilis;
• the appearance of psoriatic plaques;
• hypertonic disease;
• the patient has imperfect osteogenesis;
• Marfan and Reiter syndromes;
• Behçet's disease;
• cystic median necrosis of the aorta.

The main causes of acute aortic insufficiency:

• chest injury;
• dysfunction of the built-in valve prosthesis;
• endocarditis caused by infections;
• aortic aneurysm;
• paraprosthetic fistula.

Symptoms of the disease

The chronic form of the disease begins to manifest itself only in violation of the normal left ventricular function.

Most often, these symptoms appear:

• severe shortness of breath, even when mobility is minimized;
• bradycardia, which makes itself felt at night;

• sometimes angina may develop.

The acute form of aortic insufficiency is characterized by the following symptoms:

• severe shortness of breath;
• constant pain in the chest area;
• impotence, up to the development of fainting.

Signs of insufficiency of the aortic valve itself:

• the color of nails, cheeks, lips, palate, tongue is constantly changing;
• the pupils then narrow, then greatly expand;
• the pulse becomes too pronounced;
• there is a strong pallor of the skin.

Treatment options for aortic valve regurgitation

Treatment of such a pathology should begin immediately after diagnosis.

This is especially important when it comes to saving a child:

1. In the acute form of the disease, immediate aortic valve replacement surgery is recommended. Such surgical intervention is based on the fact that the affected valve is removed and a full-fledged prosthesis is immediately installed in its place, which can perform all the functions that the removed aortic valve does. After the operation, the patient will be required to take prescribed medications. This is especially true for vasodilators.
2. Treatment of the chronic form of pathology is mainly symptomatic. The doctor is trying to eliminate the symptoms of general malaise and heart failure. If the disease prevents the patient from living a normal life, then it is recommended to perform an operation to replace the valve with a prosthesis.
3. If the symptoms are minor, then the person can be treated at home. However, you should follow all the recommendations of the doctor, reduce all physical activity to a minimum, and also make regular visits to the cardiologist.

To optimize the work of the left ventricle itself, vasodilators are almost always prescribed.

Often prescribed:

• diuretics (Veroshpiron);
• ACE inhibitors - angiotensin-converting enzyme (Lizinopril).

A very important step is the prevention of infective endocarditis. This is especially true for patients with a valve prosthesis. The main thing is to take antibiotics after surgery.

But you should also pay attention to the points of prevention:

• removal of tonsils;
• treatment and extraction of teeth;
• operations for diseases of the gastrointestinal tract;
• surgical interventions in the urinary tract.

If all of the above rules are followed, the treatment prognosis is quite favorable.

The new prosthetic valve will perform almost as well as a normal aortic valve. In this case, the patient can almost forget about his disease.

However, you should always remember that a good condition of the prosthesis can be maintained only by correctly and clearly following all the recommendations of the doctor. If you move away from the treatment regimen or stop taking any medications at all, then the artificial valve will wear out much faster, which can lead to a severe deterioration in the patient's condition. If you correctly follow the prescribed scheme for the prevention of the further development of the disease, then it is quite possible to come to a completely normal way of life. The only thing is that a visit to a cardiologist for a preventive examination should become regular. After all, only timely diagnosis will help to determine the presence of a problem in time and begin its surgical treatment.