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Congenital Aortic Insufficiency

Congenital Aortic Valve Insufficiency


Presentation

  • […] if the condition was present at the time of inpatient admission.[icd.codes]
  • On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are[icd10data.com]
  • Stenosis - when the valve doesn't open enough and blocks blood flow Valve problems can be present at birth or caused by infections, heart attacks, or heart disease or damage.[icdlist.com]
  • METHODS: From 1954 to the present, seven children with auscultatory and physiologic characteristics of aortic regurgitation were evaluated for a total of 108 patient-years.[ncbi.nlm.nih.gov]
  • It is vital that patients with quadricuspid aortic valve who present with progressive aortic regurgitation undergo valve replacement or repair at appropriate time. Here, we present two cases of quadricuspid aortic valve.[cardiothoracicsurgery.biomedcentral.com]
Congestive Heart Failure
  • heart failure contractility coronary artery curve decrease diagnosis diastolic digitalis diuretics drug dyspnea ectopic effect ejection electrocardiogram fibers fibrillation filling findings first fluid function gallop heart disease heart sound Hemodynamic[books.google.com]
  • If not repaired or placed, a severely regurgitant valve can lead to congestive heart failure. Symptoms of congestive heart failure include swollen ankles and feet, fatigue, chest pain and shortness of breath.[sutterhealth.org]
  • People with angina or congestive heart failure due to aortic regurgitation do poorly without treatment. Call your provider if: You have symptoms of aortic regurgitation.[medlineplus.gov]
  • People with angina or congestive heart failure due to aortic regurgitation do poorly without treatment.[mountsinai.org]
Heart Disease
  • […] defect (Medical Encyclopedia) [ Read More ] Heart Valve Diseases Also called: Valvular heart disease Your heart has four valves.[icdlist.com]
  • disease heart sound Hemodynamic hypertension hypertrophy impulse increased influence left atrium left ventricle left ventricular mechanism Metabolism mitral stenosis murmur Muscle myocardial infarction myocardium normal occur oxygen pacemaker patients[books.google.com]
  • Worldwide the most common cause of aortic regurgitation is the rheumatic heart disease, particularly in the Asia, the Middle East, and the North Africa.[wikidoc.org]
  • Our arrhythmia team uses EKGs to evaluate problems including: Arrhythmias : Heartbeats that are too fast, too slow, or erratic Congenital heart disease : Birth defects in the heart Coronary artery disease : Problems with blood flow to the heart muscle[stanfordhealthcare.org]
  • Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Valvular Heart Disease, Congenital Heart Disease, CHD and Pediatrics and Quality Improvement Keywords: Infant, Infant, Newborn, Adolescent, Aortic Valve, Prospective Studies, Multivariate[acc.org]
Heart Murmur
  • The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. But many people have heart murmurs without having a problem.[icdlist.com]
  • At CHOP's Cardiac Center, we usually diagnose aortic regurgitation after a primary care doctor detects a heart murmur and refers a child to us.[chop.edu]
  • An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent flow of blood over a diseased heart valve.[nm.org]
  • Fatigue Palpitations (sensation of the heart beating) Shortness of breath with activity or when lying down Swelling of the feet, legs or abdomen Uneven, rapid, racing, pounding or fluttering pulse Weakness, more often with activity Signs may include: A heart[wexnermedical.osu.edu]
  • murmur that can be heard through a stethoscope Very forceful beating of the heart Bobbing of the head in time with the heartbeat Hard pulses in the arms and legs Low diastolic blood pressure Signs of fluid in the lungs Aortic regurgitation may be seen[medlineplus.gov]
Diastolic Murmur
  • Upon physical examination, his apical pulse was enhanced and displaced to the lateral and caudal side, and auscultation revealed a grade four diastolic murmur at the left sternal border.[cardiothoracicsurgery.biomedcentral.com]
  • This is a soft, rumbling, low-pitched, late diastolic murmur which is heard best at the apex.[med.ucla.edu]
  • Auscultation reveals an S3 and a high-pitched, decrescendo early diastolic murmur. Another characteristic diagnostic finding is widened pulse pressure.[amboss.com]
  • The hallmark diastolic murmur and bounding peripheral pulses of chronic, severe AR can be seen in other conditions. Diastolic murmurs heard in other diseases besides AR differ in their characteristics.[clinicaladvisor.com]
  • Aortic regurgitation murmur : S1 is soft and there is an early diastolic murmur, best heard in the aortic area, with the patient sitting forward and in expiration.[patient.info]
Left Ventricular Dysfunction
  • The need for surgical treatment is indicated by the appearance of a diastolic thrill, left ventricular strain on the electrocardiogram or other evidence of left ventricular dysfunction on the echocardiogram or exercise stress testing by treadmill or radionuclide[ncbi.nlm.nih.gov]
  • Left ventricular dysfunction was also occasionally seen in some cases, and the surgical outcomes for those cases were satisfactory [ 19, 20 ], as seen in our first patient who had low ejection fraction pre-operatively but recovered well with temporary[cardiothoracicsurgery.biomedcentral.com]
  • AVR should be elected after there is evidence of left ventricular dysfunction or the onset of symptoms.[thecardiologyadvisor.com]
  • In individuals with chronic severe AR and heart failure, angiotensin-converting enzyme (ACE) inhibitors or angiotensin-II receptor antagonists are useful in the presence of hypertension, when surgery is contra-indicated, or left ventricular dysfunction[patient.info]
  • Prognosis The long-term prognosis of chronic AR depends on the severity of the regurgitation and the presence of left ventricular dysfunction.[clinicaladvisor.com]
Bounding Pulse
  • This leads to a strong and forceful pulse (bounding pulse). Over time, the heart becomes less able to pump blood to the body. In the past, rheumatic fever was the main cause of aortic insufficiency.[wexnermedical.osu.edu]
  • The left lower chamber of the heart widens (dilates) and the heart beats very strongly ( bounding pulse ). Over time, the heart becomes less able to supply enough blood to the body.[medlineplus.gov]
  • Bounding pulses can be seen in other conditions causing hyperdynamic circulation such as thyrotoxicosis, pregnancy, fever, and anemia. D. Physical Examination Findings.[clinicaladvisor.com]
Impulsivity
  • […] contractility coronary artery curve decrease diagnosis diastolic digitalis diuretics drug dyspnea ectopic effect ejection electrocardiogram fibers fibrillation filling findings first fluid function gallop heart disease heart sound Hemodynamic hypertension hypertrophy impulse[books.google.com]
  • An electrocardiogram (EKG) is a test that records the electrical impulses of the heart. It assesses heart rhythm, chamber size, and muscle thickness.[stanfordhealthcare.org]
  • […] pressure Water hammer pulse of peripheral arteries characterized by rapid upstroke and downstroke Pulsing of carotid arteries with rapid upstroke and downstroke Visible capillary pulse ( Quincke sign ) Nodding of the head with each pulse Point of maximal impulse[amboss.com]
  • LV enlargement may manifest as a displaced, diffuse, and hyperdynamic apical impulse. Acute AR: In acute AR, patients are hypotensive, diaphoretic and vasoconstricted with a rapid, thready pulse.[clinicaladvisor.com]

Workup

Pericardial Effusion
  • Mild tricuspid regurgitation and minimal pericardial effusion was also found. Contrast enhanced multi-detector dual source computerized tomography also show four separated aortic cusps (Figure 2 A) with a dilated ascending aorta (Figure 2 B).[cardiothoracicsurgery.biomedcentral.com]

Treatment

  • Many children with congenital heart defects don't need treatment, but others do. Treatment can include medicines, catheter procedures, surgery, and heart transplants.[icdlist.com]
  • The need for surgical treatment is indicated by the appearance of a diastolic thrill, left ventricular strain on the electrocardiogram or other evidence of left ventricular dysfunction on the echocardiogram or exercise stress testing by treadmill or radionuclide[ncbi.nlm.nih.gov]
  • Children with mild aortic stenosis rarely require treatment. However, it is important to note that aortic stenosis may be progressive, and that children with mild disease may eventually require treatment later in life.[cincinnatichildrens.org]
  • Treatments include medications to control symptoms, and valve repair or replacement.[sutterhealth.org]
  • 12/10/2018 Depending on the severity of your aortic regurgitation, your cardiologist may recommend: Medications Surgical treatments Non-surgical, less invasive treatments To learn about the various treatment options for aortic regurgitation, keep reading[secondscount.org]

Prognosis

  • Prognosis [ 2 ] Patients with acute severe AR have a poor prognosis without intervention, due to their haemodynamic instability. Patients with chronic severe AR and symptoms also have a poor long-term prognosis.[patient.info]
  • Once your aortic valve is repaired, your prognosis is generally good. However, you’ll always need to guard against and respond quickly to any type of infections that could spread to your heart.[healthline.com]
  • […] squatting and handgrip Austin Flint murmur In more severe stages, possibly a harsh, crescendo-decrescendo mid- systolic murm u r that resembles the ejection murmur heard in aortic stenosis Screening tests (optional) References: [4] [5] [1] [2] Treatment Prognosis[amboss.com]
  • Prognosis and Patient Counseling. Prognosis The long-term prognosis of chronic AR depends on the severity of the regurgitation and the presence of left ventricular dysfunction.[clinicaladvisor.com]
  • Outlook (Prognosis) Surgery can cure aortic insufficiency and relieve symptoms, unless you develop heart failure or other complications. People with angina or congestive heart failure due to aortic regurgitation do poorly without treatment.[mountsinai.org]

Etiology

  • Classification and etiology There are numerous other predisposing factors and causes of aortic stenosis.[radiopaedia.org]
  • View Article PubMed Google Scholar Godefroid O, Colles P, Vercauteren S, Louagie Y, Marchandise B: Quadricuspid aortic valve: a rare etiology of aortic regurgitation. Eur J Echocardiogr. 2006, 7: 168-170. 10.1016/j.euje.2005.03.011.[cardiothoracicsurgery.biomedcentral.com]
  • Etiology Acute AR Infective endocarditis Aortic dissection ( ascending aorta ) Chest trauma Chronic AR Congenital bicuspid valve : most common cause of AR in young adults and in developed countries Rheumatic heart disease : most common cause of AR in[amboss.com]
  • (Etiology) Aortic Valve Regurgitation is caused due to a variety of factors, chiefly: Being born with a congenital heart condition High blood pressure may damage the heart or dilate the aorta, and also thicken the arteries Rheumatic fever Injury/trauma[dovemed.com]
  • Chronic severe AR of any etiology may lead to dilatation of the aortic root and further worsen the AR.[clinicaladvisor.com]

Epidemiology

  • "The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease". Clinical Epidemiology. 3 : 67–84. doi : 10.2147/CLEP.S12977. PMC 3046187. PMID 21386976. Bekeredjian, R.; Grayburn, PA. (2005).[wikidoc.org]
  • Epidemiology [ 2 ] Rheumatic heart disease is the most common cause of AR throughout the world. In developed countries, congenital and degenerative valve abnormalities are the most common cause and the peak age of presentation is 40-60 years.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Anomalous coronary artery arising from the opposite sinus: descriptive features and pathophysiologic mechanisms, as documented by intravascular ultrasonography. J Invasive Cardiol 2003; 15: 507–14.[link.springer.com]
  • ., Marfan syndrome, Ehlers-Danlos syndrome) Tertiary syphilis See also heart valve disease References: [1] [2] Pathophysiology General Regurgitation of blood from the aorta into the left ventricle (LV) Increased systolic blood pressure and decreased diastolic[amboss.com]
  • Clinical and pathophysiological implications of a bicuspid aortic valve. Circulation. 2002;106:900-4. Medline 2. Nistri S, Sorbo MD, Marin M, Palisi M, Scognamiglio R, Thiene G.[revespcardiol.org]

Prevention

  • At surgery, the fibrous band was stretching the non-coronary cusp so that it prevented coaptation of the aortic valve. The situation was termed by us as the 'kite anomaly'.[ncbi.nlm.nih.gov]
  • Usually closing the VSD surgically will fix the problem and prevent any progression in further leaking of the aortic valve. Less common causes of aortic valve insufficiency include infections and other inflammatory conditions.[pediatricheartspecialists.com]
  • There are valves that prevent the blood from flowing the wrong way.[dovemed.com]
  • It is usually caused by rheumatic fever, and is rare in the United States, where antibiotics are used to prevent serious infections. Treatments include medications to control symptoms, and valve repair or replacement.[sutterhealth.org]
  • Make sure it's well-controlled to prevent aortic regurgitation. Aug. 02, 2017[mayoclinic.org]

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