Aortic stenosis: From diagnosis to optimal treatment
Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Serbian Medical Society
2008-01-01
|
| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790804176T.pdf |
| _version_ | 1819238488610963456 |
|---|---|
| author | Tavčiovski Dragan Davičević Žaklina |
| author_facet | Tavčiovski Dragan Davičević Žaklina |
| author_sort | Tavčiovski Dragan |
| collection | DOAJ |
| description | Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery. |
| first_indexed | 2024-12-23T13:37:01Z |
| format | Article |
| id | doaj.art-455f28a2d78f406f80ced41669e76291 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-23T13:37:01Z |
| publishDate | 2008-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-455f28a2d78f406f80ced41669e762912022-12-21T17:44:59ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792008-01-011363-417618010.2298/SARH0804176TAortic stenosis: From diagnosis to optimal treatmentTavčiovski DraganDavičević ŽaklinaAortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery.http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790804176T.pdfaortic stenosisdiagnostic methodsmedical treatmentoperative risk stratificationsurgical treatment |
| spellingShingle | Tavčiovski Dragan Davičević Žaklina Aortic stenosis: From diagnosis to optimal treatment Srpski Arhiv za Celokupno Lekarstvo aortic stenosis diagnostic methods medical treatment operative risk stratification surgical treatment |
| title | Aortic stenosis: From diagnosis to optimal treatment |
| title_full | Aortic stenosis: From diagnosis to optimal treatment |
| title_fullStr | Aortic stenosis: From diagnosis to optimal treatment |
| title_full_unstemmed | Aortic stenosis: From diagnosis to optimal treatment |
| title_short | Aortic stenosis: From diagnosis to optimal treatment |
| title_sort | aortic stenosis from diagnosis to optimal treatment |
| topic | aortic stenosis diagnostic methods medical treatment operative risk stratification surgical treatment |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790804176T.pdf |
| work_keys_str_mv | AT tavciovskidragan aorticstenosisfromdiagnosistooptimaltreatment AT daviceviczaklina aorticstenosisfromdiagnosistooptimaltreatment |