对大动脉反的当代评估和临床治疗选择
Mark Lebehn1, Torsten Vahl1,2, Polydoros Kampaktsis1
1Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA.
Journal of cardiovascular development and disease
|September 27, 2023
概括
大动脉反 (AR) 影响了许多老年人. 准确评估AR严重程度及其对左心室的影响对于及时干预和改善结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 膜心脏疾病 膜心脏疾病
- 医疗成像医学成像
背景情况:
- 大动脉反 (AR) 是一种普遍的膜心脏病,随着年龄的增长而增加.
- 了解大动脉和根结构是AR病因和机制的关键.
- 急性和慢性AR有不同的血液动力学影响和管理策略.
研究的目的:
- 在老龄化人口中审查大动脉反 (AR) 的重要性.
- 讨论急性与慢性AR的不同血液动力学影响和管理.
- 突出需要多参数成像来评估AR严重程度和左心室功能.
主要方法:
- 关于大动脉反 (AR) 病理生理学和管理的当前文献的综述.
- 对诊断成像方式的分析,包括心声学,CT和CMR.
- 评估新兴的透导管疗法和对AR的评估方法.
主要成果:
- 目前的指导方针可能导致慢性AR的延迟干预,影响结果.
- 多参数成像对于准确量化心室功能和AR严重程度至关重要.
- 心声图是主要的,CT和CMR补充.
结论:
- 准确评估AR严重程度和LV功能对于最佳患者结果至关重要.
- 需要新的成像和治疗方法来改善管理,特别是对高风险患者.
- 及时干预,以全面的成像为指导,是管理大动脉吐的关键.
更多相关视频
相关概念视频
Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Aortic Regurgitation IV: Nursing Management
30
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
30
Mitral Regurgitation III: Medical Management
18
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
18
Aneurysm III: Interprofessional Care
9
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
9


