What are the causes of aortic calcification?

Aortic calcification is a disease with a relatively high incidence in the elderly. After suffering from this disease, some of the patient's blood vessels begin to calcify, accompanied by symptoms such as angina pectoris and shortness of breath. Aortic calcification is generally caused by the gradual aging of the human body and a significant decrease in the elasticity of blood vessels. It can be said that this disease is also a sign of aging! Currently, there is no complete cure for aortic calcification in medicine, but further development of the disease can be prevented through a reasonable diet, moderate exercise, and necessary examinations and treatments under the guidance of a doctor. There are many types of aortic calcification, and different types of the disease are triggered by different factors.

1. Congenital aortic valve disease

The most common form is bicuspid valve deformity, with aortic valve stenosis as the main clinical manifestation. The transvalvular pressure gradient during aortic valve systole often exceeds 13.3 kPa (100 mmHg). The electrocardiogram shows high left ventricular voltage, often accompanied by strain. X-ray angiography and ultrasound examination often show that the left ventricular cavity is small and the myocardium is concentrically hypertrophied. Severe aortic stenosis may cause relative mitral regurgitation due to excessive left ventricular systolic pressure.

Another common congenital aortic valve disease is aortic valve leaflet prolapse resulting in aortic regurgitation, which often occurs in cases of large high ventricular septal defect or aortic valve sinus aneurysm rupturing into the right ventricle. In cases of larger high-position ventricular septal defect, the corresponding valve leaflets above it lose support from the ventricular septum, and the valve leaflets prolapse into the right ventricle through the ventricular septum during ventricular diastole. In cases of ruptured sinus of Valsalva aneurysm, the corresponding aortic valve leaflet prolapses into the left ventricle.

2. Aortic valve disease

About 20% of rheumatic mitral valve disease is associated with aortic valve disease.

In rheumatic heart disease, simple aortic valve disease is less common. The three leaflets of the aortic valve are all fibrotic, thickened, contracted, hardened, and even calcified, with very poor mobility. Therefore, rheumatic aortic valve disease is often a double lesion of stenosis and insufficiency, with a long course of disease and more serious heart function damage.

3. Degenerative changes of aortic valve

The aortic valve leaflets show myxoid changes, the tissue is thin and translucent, and cannot withstand the diastolic pressure in the aorta, resulting in insufficiency. It is common in ascending aortic aneurysms caused by syphilitic aortitis, Marfan syndrome, medial aortic necrosis, senile degenerative changes and other reasons. Due to severe incompetence of the aortic valve, the pulse pressure of the peripheral arteries was significantly widened. In terms of hemodynamics, the left ventricle had a severe volume load increase, so the left ventricle enlarged to the left, downward, and backward. Both left ventriculography and ultrasound examination showed that the left ventricular cavity was significantly enlarged and the aortic valve had severe regurgitation. The contrast agent flows back and forth in the left ventricle and ascending aorta, where it stays for a long time and cannot be emptied quickly.

4. Bacterial endocarditis

Bacterial endocarditis often damages the aortic valve leaflets, causing vegetation, perforations or tears on the leaflets. Therefore, clinically, aortic valve disease caused by bacterial endocarditis often manifests as aortic valve insufficiency. Due to the short course of the disease and rapid changes in hemodynamics, the left ventricle cannot tolerate the sudden increase in volume load. In addition, the vegetation may break off and cause embolism of systemic arteries.