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Aortic stenosis is the narrowing of the exit of the left ventricle of the heart, such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include shortness of breath especially when lying down, at night, or with exercise, and swelling of the legs. Thickening of the valve without causing obstruction is known as aortic sclerosis.
The mitral valve, also known as the bicuspid valve or left atrioventricular valve, is one of the four heart valves. It has two cusps or flaps and lies between the left atrium and the left ventricle of the heart. The heart valves are all one-way valves allowing blood flow in just one direction. The mitral valve and the tricuspid valve are known as the atrioventricular valves because they lie between the atria and the ventricles.
A ventricle is one of two large chambers located toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles, while intraventricular means within one ventricle.
Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an echocardiogram, a cardiac echo, or simply an echo.
An ejection fraction (EF) is the volumetric fraction of fluid ejected from a chamber with each contraction. It can refer to the cardiac atrium, ventricle, gall bladder, or leg veins, although if unspecified it usually refers to the left ventricle of the heart. EF is widely used as a measure of the pumping efficiency of the heart and is used to classify heart failure types. It is also used as an indicator of the severity of heart failure, although it has recognized limitations.
Pulse pressure is the difference between systolic and diastolic blood pressure. It is measured in millimeters of mercury (mmHg). It represents the force that the heart generates each time it contracts. Healthy pulse pressure is around 40 mmHg. A pulse pressure that is consistently 60 mmHg or greater is likely to be associated with disease, and a pulse pressure of 50 mmHg or more increases the risk of cardiovascular disease. Pulse pressure is considered low if it is less than 25% of the systolic. A very low pulse pressure can be a symptom of disorders such as congestive heart failure.
Afterload is the pressure that the heart must work against to eject blood during systole. Afterload is proportional to the average arterial pressure. As aortic and pulmonary pressures increase, the afterload increases on the left and right ventricles respectively. Afterload changes to adapt to the continually changing demands on an animal's cardiovascular system. Afterload is proportional to mean systolic blood pressure and is measured in millimeters of mercury.
Hypertrophic cardiomyopathy is a condition in which muscle tissues of the heart become thickened without an obvious cause. The parts of the heart most commonly affected are the interventricular septum and the ventricles. This results in the heart being less able to pump blood effectively and also may cause electrical conduction problems. Specifically, within the bundle branches that conduct impulses through the interventricular septum and into the Purkinje fibers, as these are responsible for the depolarization of contractile cells of both ventricles.
Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a consequence, the cardiac muscle is forced to work harder than normal.
A cardiac stress test is a cardiological examination that evaluates the cardiovascular system's response to external stress within a controlled clinical setting. This stress response can be induced through physical exercise or intravenous pharmacological stimulation of heart rate.
Left ventricular hypertrophy (LVH) is thickening of the heart muscle of the left ventricle of the heart, that is, left-sided ventricular hypertrophy and resulting increased left ventricular mass.
Valvular heart disease is any cardiovascular disease process involving one or more of the four valves of the heart. These conditions occur largely as a consequence of aging, but may also be the result of congenital (inborn) abnormalities or specific disease or physiologic processes including rheumatic heart disease and pregnancy.
Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventricle contracts (systole). TR allows the blood to flow backwards from the right ventricle to the right atrium, which increases the volume and pressure of the blood both in the right atrium and the right ventricle, which may increase central venous volume and pressure if the backward flow is sufficiently severe.
Arterial stiffness occurs as a consequence of biological aging and arteriosclerosis. Inflammation plays a major role in arteriosclerosis development, and consequently it is a major contributor in large arteries stiffening. Increased arterial stiffness is associated with an increased risk of cardiovascular events such as myocardial infarction, hypertension, heart failure and stroke, the two leading causes of death in the developed world. The World Health Organization predicts that in 2010, cardiovascular disease will also be the leading killer in the developing world and represents a major global health problem.
Aortography involves placement of a catheter in the aorta and injection of contrast material while taking X-rays of the aorta. The procedure is known as an aortogram. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen. The catheter has to be inserted through the right femoral artery, because in about two-thirds of cases the aortic dissection spreads into the left common iliac artery.
Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; this may be measured by echocardiography or cardiac catheterization. Approximately half of people with heart failure have preserved ejection fraction, while the other half have a reduction in ejection fraction, called heart failure with reduced ejection fraction (HFrEF).
Tissue Doppler echocardiography (TDE) is a medical ultrasound technology, specifically a form of echocardiography that measures the velocity of the heart muscle (myocardium) through the phases of one or more heartbeats by the Doppler effect of the reflected ultrasound. The technique is the same as for flow Doppler echocardiography measuring flow velocities. Tissue signals, however, have higher amplitude and lower velocities, and the signals are extracted by using different filter and gain settings. The terms tissue Doppler imaging (TDI) and tissue velocity imaging (TVI) are usually synonymous with TDE because echocardiography is the main use of tissue Doppler.
Left ventricular thrombus is a blood clot (thrombus) in the left ventricle of the heart. LVT is a common complication of acute myocardial infarction (AMI). Typically the clot is a mural thrombus, meaning it is on the wall of the ventricle. The primary risk of LVT is the occurrence of cardiac embolism, in which the thrombus detaches from the ventricular wall and travels through the circulation and blocks blood vessels. Blockage can be especially damaging in the heart or brain (stroke).
Right heart strain is a medical finding of right ventricular dysfunction where the heart muscle of the right ventricle (RV) is deformed. Right heart strain can be caused by pulmonary hypertension, pulmonary embolism, RV infarction, chronic lung disease, pulmonic stenosis, bronchospasm, and pneumothorax.
Gillian Amanda Whalley is a New Zealand Professor of Clinical Sonography at the University of Otago.
References
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- ↑ Myerson, Saul G.; Bellenger, Nicholas G.; Pennell, Dudley J. (March 2002). "Assessment of Left Ventricular Mass by Cardiovascular Magnetic Resonance". Hypertension. 39 (3): 750–755. doi:10.1161/hy0302.104674. ISSN 0194-911X. PMID 11897757.
- ↑ Stokar, Joshua; Leibowitz, David; Durst, Ronen; Shaham, Dorith; Zwas, Donna R. (2019-10-24). "Echocardiography overestimates LV mass in the elderly as compared to cardiac CT". PLOS ONE. 14 (10): e0224104. Bibcode:2019PLoSO..1424104S. doi: 10.1371/journal.pone.0224104 . ISSN 1932-6203. PMC 6812823 . PMID 31648248.
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- ↑ Levy, Daniel; Garrison, Robert J.; Savage, Daniel D.; Kannel, William B.; Castelli, William P. (1990-05-31). "Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study". New England Journal of Medicine. 322 (22): 1561–1566. doi:10.1056/NEJM199005313222203. ISSN 0028-4793. PMID 2139921.
- ↑ Kawel-Boehm, Nadine; Kronmal, Richard; Eng, John; Folsom, Aaron; Burke, Gregory; Carr, J. Jeffrey; Shea, Steven; Lima, João A. C.; Bluemke, David A. (October 2019). "Left Ventricular Mass at MRI and Long-term Risk of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)". Radiology. 293 (1): 107–114. doi:10.1148/radiol.2019182871. ISSN 1527-1315. PMC 6776886 . PMID 31453766.
- ↑ Laukkanen, Jari A.; Khan, Hassan; Kurl, Sudhir; Willeit, Peter; Karppi, Jouni; Ronkainen, Kimmo; Di Angelantonio, Emanuele (2014-12-17). "Left Ventricular Mass and the Risk of Sudden Cardiac Death: A Population-Based Study". Journal of the American Heart Association. 3 (6). doi:10.1161/JAHA.114.001285. ISSN 2047-9980. PMC 4338721 . PMID 25376188.
- ↑ Schillaci, Giuseppe; Verdecchia, Paolo; Porcellati, Carlo; Cuccurullo, Olga; Cosco, Carmela; Perticone, Francesco (February 2000). "Continuous Relation Between Left Ventricular Mass and Cardiovascular Risk in Essential Hypertension". Hypertension. 35 (2): 580–586. doi:10.1161/01.HYP.35.2.580. ISSN 0194-911X.
- ↑ Koren, M (December 2002). "Left ventricular mass change during treatment and outcome in patients with essential hypertension". American Journal of Hypertension. 15 (12): 1021–1028. doi:10.1016/s0895-7061(02)03061-3. ISSN 0895-7061.
- ↑ Hatani, Takeshi; Kitai, Takeshi; Murai, Ryosuke; Kim, Kitae; Ehara, Natsuhiko; Kobori, Atsushi; Kinoshita, Makoto; Kaji, Shuichiro; Tani, Tomoko; Sasaki, Yasuhiro; Yamane, Takafumi; Koyama, Tadaaki; Nasu, Michihiro; Okada, Yukikatsu; Furukawa, Yutaka (September 2016). "Associations of residual left ventricular and left atrial remodeling with clinical outcomes in patients after aortic valve replacement for severe aortic stenosis". Journal of Cardiology. 68 (3): 241–247. doi:10.1016/j.jjcc.2015.09.017. ISSN 1876-4738. PMID 26527112.
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