[Clinico-functional characteristics of minimally pronounced aortal insufficiency]

Fifty-five patients with "pure" aortal failure (AF) aged 16 to 48 years were examined. There were 39 men and 16 women. Of these, 22 patients presented with minimal, 20 with moderate, and 13 with pronounced AF. The protodiastolic murmur regarded as the most significant clinical sign could be heard in 19 out of the 22 patients with minimal AF, which appears to be determined by high frequency oscillations connected with the protodiastolic murmur. During phonocardiographic studies, that murmur was recorded only in 8 patients (36.6 percent) with minimal AF. Analysis of the ECG readings identified the signs of insignificant hypertrophy of the left ventricle (LV) only in 5 out of the 22 patients. The employment of Doppler's ultrasound cardiography made it possible to record the reverse blood flow in the left ventricle cavity in all the cases. In patients with minimal AF, the ultrasound cardiography did not discover any enlargement of the size, thickness of the walls or mass of the LV myocardium. Myocardial contractility, the stroke and cardiac indices remained within normal. However, there was a decrease in the effective ejection fraction of the LV. The typical "vibration" of the anterior cusp of the mitral valve was demonstrable in all AF patients. Thus the clinical and instrumental examination of patients with minimal AF permitted revealing the definite diagnostic characteristics which should be taken into consideration to recognize the heart disease under discussion.