In: Anatomy and Physiology
A 66-year-old man went to his doctor for evaluation of ongoing episodes of chest pain, being lightheaded and shortness of breath with exertion, 2 weeks ago he fainted while going up the stairs. His chart showed a heavy calcified aortic valve and his valve area is 40% of its normal size.
What is the most likely diagnosis for this patient's condition?
if the patient is not treated in time what will happen, to his stroke volume?
what are the treatment options?
Answer.
Data given - patient male with age 66
Symtpoms - chest pain ongoing episodes , lightheaded , shortness of the breath with exertion from 2 weeks , fainted
Finding - calcified aortic valve , valve area is 40% of normal size.
Now Diagnosis so the diagnosis is the aortic valve stenosis , patient is suffering from the aortic valve stenosis in which valve gets narrow and thickened due to the deposition of the calcium , this problem usually occurs after the age of 65 which shows first confirmatory diagnosis point as the age of the patient is 66 here.
In the aortic valve stenosis there is decrease in the outflow of the blood from.the ventricle and supply somehow gets disturbed and pressure increased in the ventricle causes the symptoms like chest pain , light headedness shortness of breath etc.
So it is the problem of aortic stenosis which is the confirmed diagnosis if there will not be proper treatment given it will effect the stroke volume as the stroke volume use to fall.
By the stage of mild stenosis conditions gets into the control but in moderate and severe cases as given in condition 40% comes in the moderate and in this case the stroke volume starts falling because there will be gradually increase in the end-systolic volume and decrease in the end-diastolic volume.
End-systolic volume is the amount of blood that is left in each ventricle after the ejection period or phase.
End diastolic volume is the total amount of blood filled in the ventricle at the end of filling phase.
So the stroke volume will increase if this problem is left untreated for a long time and its very dangerous.
Treatment options are most safer are surgery in this case because there are some sort of medicines that can be given but they usually works as the symptomatic relief.
There are ACE inhibitors , beta blockers are given for symptomatic relief but as a treatment surgery is suggested.
There are mainly two things are seen in the case of aortic stenosis and they are.
1 ) So in the first balloon vulvuloplasty is ths process in which thin long rubber tube like valve is inserted into the body from.the groin to the heart and so by this process the valves gets controlled. As balloon inlfates it stretches the valve.
2) TAVR it is suggested if the case is severe and open heart surgery is not possible so this is done in this threaded valve is inserted into the artery through the femoral path or from the chest.
Or we can also go for open heart surgery.
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