Department of cardiac muscle pathology and transplantation of organs and tissues

mitral insufficiency

Aortic valve insufficiency: causes, symptoms, diagnosis and treatment.

Aortic valve insufficiency (AVI) is a defect in which the reverse blood flow from the aorta during diastole occurs due to the valve insufficiency, which is unable to fully close the lumen of the aortic orifice.


There are acute AVI (during melting, ulceration, rupture of valve leaflets by infectious, inflammatory or traumatic agents) and chronic AVI. The most common cause is rheumatic affections. Other causes of AVI formation are other autoimmune diseases (scleroderma, SLE, RA), somatic diseases (hypertension, atherosclerosis, dissection of the aortic aneurysm, parasitosis, tumors).


About 20% of AVI cases are acute (infectious endocaditis, trauma of the heart, concomitant valve damage in the process of aortic aneurysm dissection, etc.). This condition is accompanied by a rapid grow of heart failure symptoms and decompensation of blood circulation. This requires immediate surgical intervention.
With the formation of chronic AVI the symptoms develop slowly. First, cardiac remodeling takes place in order to compensate homeostasis parameters. With the depletion of heart muscle resources, there is a sensation of strong heart pushes, pulsations in the head, shortness of breath, pain in the heart, first under load, and later at rest. Pale skin, "carotid shudder", "pulsating" pupils, tonsils and staphyle, dizziness and fainting, tinnitus are characteristic. Later the symptoms of heart failure with edematous syndrome develop.


  • Laboratory studies (common blood test, rheumatological tests, blood culture for sterility, serological diagnosis (RW), biochemical blood test);
  • Phonocardiography, ECG, echocardioscopy;
  • Ultrasound of abdomen, doplerography of large vessels;
  • Physical examination, incl. percussion, palpation, auscultation, blood pressure check;
  • X-ray study of thoracic organs in several projections, ventriculography, coronary angiography;
  • Catheterization of heart chambers.


In acute AVI, balloon counterpulsation, followed by the aortic valve replacement on the treatment of the underlying disease is performed as an emergency aid. In chronic AVI in the stage of compensation, medicamental correction of symptoms, improvement of cardiac activity and circulatory function with the use of nitrates, anticoagulants, ACE inhibitors, etc., are carried out. In the presence of indications, surgical treatment is used: balloon valvuloplasty is performed in the early stages of the disease, without gross organic changes, but in case of severe lesion of the valves and pronounced regurgitation, aortic valve replacement is carried out.



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