Aortic Valve: Difference between revisions

11 bytes removed ,  10 February 2015
no edit summary
No edit summary
No edit summary
Line 4: Line 4:
[[Image:Aovalv.svg|300px]]
[[Image:Aovalv.svg|300px]]


With 2D echocardiography, the valve can be assessed in the Plax, where one sees the RCC and the NCC. In a normal aortic tricuspid valve closure line is then between the RCC and NCC is usually in the center of the aortic valve ring. One sees better the aortic valve in the PSAXao however, where the three cusps in systole almost form a circle and diastole in an inverted Mercedes-Benz logo. Assessing the number of cusps is done in systole, because the valve is open and because in the closed position can be seen as a raphe purse line. With 3D echocardiography you can now get wonderful images of the aortic valve.
With 2D echocardiography, the valve can be assessed in the PLAX, where one sees the RCC and the NCC. In a normal aortic tricuspid valve, the closure line is between the RCC and NCC and usually in the center of the aortic valve ring. However, the aortic valve can be even better assessed in the PSAXao, where the three cusps in systole almost form a circle and in diastole in an inverted Mercedes-Benz logo. Assessing the number of cusps is done in systole, because the valve is open and because in the closed position raphes can be misinterpreted. With 3D echocardiography you can now also get wonderful images of the aortic valve.


{| class="wikitable" cellpadding="0" cellspacing="0" border="0"
{| class="wikitable" cellpadding="0" cellspacing="0" border="0"
Line 31: Line 31:


==Bicuspid aortic valve==
==Bicuspid aortic valve==
Bicuspid aortic valve is the most common cardiac valve abnormality. Here are two leaflets fused at the development. A bicuspid aortic valve occurs in 1-2% of the population and twice as often in men as in women.
The bicuspid aortic valve is the most common cardiac valve abnormality. Here are two leaflets fused during the development. A bicuspid aortic valve occurs in 1-2% of the population and twice as often in men compared to women.


A bicuspid aortic valve can be hereditary, both familial clustering and isolated valve defects are documented. The incidence of bicuspid aortic valve may reach 10% in certain families. A bicuspid aortic valve is often associated with other congenital heart defects, including coarctation of the aorta. Usually there is a fusion between the LCC and RCC (70%). In many cases, the bicuspid aortic valve do not cause any problems. Later in life, the valve will calcify early causing a stenosis occurs and possibly leak through malcoaptatie of the affected cusps.
A bicuspid aortic valve can be hereditary, both familial clustering and isolated valve defects are documented. The incidence of bicuspid aortic valve may reach 10% in certain families. A bicuspid aortic valve is often associated with other congenital heart defects, including coarctation of the aorta. Usually there is a fusion between the LCC and RCC (70%). In many cases, the bicuspid aortic valve does not cause any problems. Later in life, the valve will calcify early causing a stenosis and possibly also regurgitation through malcoaptation of the affected cusps.


==Stenosis==
==Stenosis==
Line 50: Line 50:
|'''Valvular:'''
|'''Valvular:'''
|
|
*Congenital form; often than bicuspid aortic valve
*Congenital form; often bicuspid aortic valve
*Due to rheumatic fever
*Due to rheumatic fever
*Degenerative form
*Degenerative form
Line 58: Line 58:
*Congenital anomaly: a membrane in LVOT
*Congenital anomaly: a membrane in LVOT
*Hypertrophic obstructive cardiomyopathy, an autosomal dominant hereditary disorder
*Hypertrophic obstructive cardiomyopathy, an autosomal dominant hereditary disorder
*Aortic subvalvular stenosis has also been described as a result of any of the lysosomal storage diseases
*Aortic subvalvular stenosis has also been described as a result of lysosomal storage diseases
|}
|}


Some patients have no symptoms, sudden, unexpected death, the first phenomenon. Fatigue, shortness of breath and lack of oxygen during exertion, chest pain and dizziness and fainting during exercise are further symptoms. The left ventricle must be at a higher pressure aortic valve stenosis in order to generate gain. Blood in the aorta rises in the long run by left ventricular pressure load. Depending on the severity and cause of the problem, a valve replacement may be indicated.
Some patients have no symptoms, but sudden, unexpected death may be the first phenomenon. Fatigue, shortness of breath and lack of oxygen during exertion, chest pain and dizziness and fainting during exercise are other symptoms. The left ventricle must develop higher pressures in aortic valve stenosis in order to generate an adequate blood pressure. Depending on the severity and cause of the problem, a valve replacement may be indicated.


Click [[Aortic Valve Stenosis|'''here''']] for quantification of aortic valve stenosis.
Click [[Aortic Valve Stenosis|'''here''']] for quantification of aortic valve stenosis.
Line 92: Line 92:
|}
|}


A serious aortic regurgitation causes a volume overload of the left ventricle. Since the blood that has been pumped out, must be pumped back in touches the left ventricular causing overload and heart failure occurs. Patients complain of fatigue and shortness of breath. The valve, and possibly a part of the aortic arch, can be replaced.
A serious aortic regurgitation causes a volume overload of the left ventricle. Since the blood that has just been ejected, returns immediately and causes left ventricular overload and subsequently heart failure may occur. Patients complain of fatigue and shortness of breath. The valve, and possibly a part of the aortic arch, may be replaced.


Click [[Aortic Valve Insufficiency|'''here''']] for quantification of aortic valve insufficiency.
Click [[Aortic Valve Insufficiency|'''here''']] for quantification of aortic valve insufficiency.
0

edits