Coronary Artery Disease
定义
主动脉瓣狭窄 (AS) is a narrowing of the 主动脉瓣 opening. This valve controls the flow of blood from the 心 to a large artery called the aorta. This artery carries blood from the 心 to the rest of body.
AS makes it hard for blood to leave the 心. 它可以减少 the amount of blood that goes to the body and 导致 a backup of blood into the 心. This backup can raise pressure in the 心 and lungs. AS can range from mild to 严重的.
原因
The 主动脉瓣 has 3 flaps that should open and close smoothly. AS is 导致d by a problem with these flaps. Common reasons for the problems are:
- A person is born with an 主动脉瓣 that has 2 parts, or cusps, not 3
- A 2 part 主动脉瓣 narrows with wear and tear over time
- An 主动脉瓣 has only 1 cusp or was narrow from birth
- The valve hardens or calcium builds up over time as a person ages
- The 主动脉瓣 is scarred due to 风湿性 发热-这很罕见
风险因素
This condition is more common in men.
Things that may raise the risk of AS include:
- Family members with 心 valve problems
- History of 风湿性 发热
- High 血压
- 高胆固醇
- 糖尿病
- 吸烟
症状
A person with AS does not always have symptoms. 一个人的症状 可能有:
- When working out or doing something that takes effort:
- 快速或 irregular 心beat
- Shortness of breath
- a的症状 中风 or transient ischemic 攻击
Rarely, AS can 导致 abnormal 心 rhythms or sudden death with no symptoms before.
诊断
The doctor will ask about symptoms and past health. 一个物理 检查就完成了. The doctor may be alerted to AS by the following:
- Odd chest 声音s such as a 心杂音 或者点击 声音
- Noticeable chest heave or vibration when the doctor's hand is held over the 心
Images may need to be taken of the chest with:
治疗
The goals of treatment are to reduce pressure on the 心 and lungs and manage symptoms. People with mild AS may need to be checked often. 他们可能 not need treatment right away.
People with more 严重的 AS may:
- Be asked to avoid intense physical activity.
- Be given medicine to decrease pressure on the 心 and help prevent 心 失败.
- Have surgery to repair the valve.
药物
Vasodilators may be given to widen blood vessels and decrease 血压. Statins can help lower cholesterol.
手术
Surgical options include:
- Balloon valvuloplasty—A balloon device is passed through the arteries to open or enlarge the stenotic 主动脉瓣. This may help symptoms for a short time. The valve can get blocked 再一次。.
- 主动脉瓣 更换—An incision is made in the chest to put in a donor valve, tissue valve (from animal tissue), or a man made valve.
- Transcatheter 主动脉瓣 更换 (TAVR)—A small incision is made in the leg 或胸部. A wire is passed through the incision to the 心. 更换 valve is sent through the wire and is placed within the original valve. 这并 not need as big of an incision as open surgery.
| Aortic Valve Replacement—Mechanical and Bioprosthetic Valve Shown |
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Lower the Risk of Problems
People with AS can take steps to try to avoid problems it can 导致.
Get regular health care, including exams and tests.
Some people with AS may need antibiotics before dental or medical procedures. This could prevent 心 infections. 问医生是否 antibiotics should be taken before getting medical or dental work done.
预防
AS cannot be prevented.
参考文献
- Antibiotic prophylaxis for 心 patients. 口 Healthy—American Dental Association website. 可以在: http://www.mouthhealthy.org/en/az-topics/a/premedication-or-antibiotics.
- 主动脉瓣狭窄. EBSCO DynaMed website. 可以在: http://www.力学.com/condition/aortic-stenosis.
- Grimard B.H.萨福德，R.E.等。. 主动脉瓣狭窄: diagnosis and treatment. Am Fam Physician, 2016; 93 (5): 371-378.
- Infective endocarditis. American 心 Association website. 可以在: http://www.心.org/en/health-topics/infective-endocarditis.