What is this?

Aortic insufficiency is a frequent valvulopathy.

Causes and risk factors

The aortic valve does not close completely. The blood ejected from the left ventricle to the aorta can therefore flow back, overloading the work of the left ventricle which increases in volume. Left ventricular failure is progressively developed.

Signs of the disease

Aortic insufficiency is often associated with other valvulopathies: aortic stenosis, mitral valvulopathy etc., making the diagnosis and surgical decision complex.

Additional examinations and analyzes

Aortic insufficiency may be secondary to multiple diseases, but other causes are possible: Osler endocarditis, atherosclerosis, syphilis, aortic dissection, congenital malformation, thoracic trauma, ankylosing spondylitis, autoimmune diseases, acute rheumatic fever. In some countries.

Processing

The bacterial graft (Osler's endocarditis) is particularly frequent on this valvulopathy.

Often, the condition is latent and is only found during shortness of breath and chest pain. At cardiac auscultation there is a mild diastolic murmur, that is to say an abnormal sound beginning just after the second (B2) noise and extinguishing before the first sound (B1). Signs of arterial hyperpulsatility (pulse ample, leaping, depressible with sign of the dance of the carotid arteries). The blood pressure shows an enlarged differential: increased systolic pressure and decreased diastolic pressure (1 ° upper limit and 2 ° lower minimum).

They confirm left ventricular hypertrophy

No surgery is currently performed without a hemodynamic and angiographic assessment. It is therefore for the purpose of discussing an intervention that these explorations are practiced.

It is first medical

Procedures to replace the aortic orifice with a valvular prosthesis have become common (open-heart surgery under CEC: extracorporeal circulation). Long-term anticoagulant therapy is required after surgery.

Radiography and radiography: cardiomegaly (large heart); Cardiac ultrasound; Electrocardiogram; Angiography reflux and myocardial scintigraphy, a non-invasive technique.

Prevention of osler endocarditis and acute rheumatic fever (antibiotics)