Aortic stenosis grading

Aortic stenosis can lead to poor blood circulation, causing chest tightness and pain, which should attract our attention. For patients with aortic valve stenosis, they should avoid excessive fatigue in daily life, go to the hospital for follow-up in time to eliminate the risk of disease. During the onset period, they should pay more attention to the cultivation of healthy diet and living habits, eat more fruits and vegetables, and avoid spicy and greasy foods. So, how is aortic stenosis graded?

1. The valve area of ​​a normal adult is about 3.0 to 4.0 cm2. According to the degree of stenosis, aortic valve stenosis can be divided into mild stenosis (valve area ≥1.5 cm2), moderate stenosis (valve area 1.0 to 1.5 cm2) and severe stenosis (valve area ≤1.0 cm2).

Some also classify the disease according to the transvalvular pressure gradient of the valve. An average transvalvular pressure gradient of less than 30 mmHg is mild, 30-50 mmHg is moderate, and greater than 50 mmHg is severe.

2. Clinical manifestations

1. Angina

60% of patients have symptoms, which are often induced by exercise and relieved by rest. It occurs after exertion or when resting, indicating that it is not necessarily related to exertion and physical activity. The mechanism of its occurrence may be related to myocardial hypertrophy, increased myocardial oxygen demand and reduced oxygen supply secondary to excessive compression of the coronary arteries, and excessive left ventricular wall tension during systole.

2. Dizziness or fainting

About 30% of patients experience dizziness or syncope, which can last from as short as 1 minute to more than half an hour. Some patients also have Adams-Stokes syndrome or arrhythmia. Dizziness or syncope often occurs after labor or when the body is bent forward, and sometimes is induced at rest by sudden changes in body position or sublingual nitroglycerin for the treatment of angina pectoris. The mechanism of its occurrence is still unclear, but it may be related to the following factors: ① Labor causes peripheral blood vessels to dilate, and the narrow aorta limits the corresponding increase in cardiac output capacity, leading to insufficient blood supply to the brain. ② Transient severe arrhythmias occur, leading to hemodynamic disorders. ③Carotid sinus allergy.

3. Difficulty breathing

Exertional dyspnea is often a sign of heart failure and is often accompanied by fatigue and weakness. As heart failure worsens, paroxysmal nocturnal dyspnea, orthopnea, and coughing up pink frothy sputum may occur.

4. Sudden Death

It accounts for 10% to 20%. In most cases, sudden death is often preceded by repeated angina pectoris or syncope, but it can also be the first symptom. Its occurrence may be related to serious and fatal arrhythmias, such as ventricular fibrillation.

5. Excessive sweating and palpitations

This type of patients sweat a lot. Due to increased myocardial contraction and arrhythmia, patients often feel palpitations. Excessive sweating often occurs after palpitations, which may be related to autonomic nervous system dysfunction and increased sympathetic nerve tension.