2. Aortic insufficiency ( Aortic regurgitation)

Question 1

Aortic insufficiency definition?

Answer 1

Aortic insufficiency occurs either alone, or more frequently in combination with aortic stenosis or
mitral defect.

Question 2

Cause of aortic insufficiency?

Answer 2

The most frequent cause is rheumatic fever, less frequently atherosclerosis of the
valvular cusps, bacterial endocarditis and syphilitic aortitis.

Question 3

Functional impairment?

Answer 3

The basic functional impairment in insufficiency of aortic valve is represented
by reverse blood flow from aorta back into the left ventricle during the ventricular diastole. The left
ventricle is filled simultaneously by both the blood from the left atrium and regurgitated blood from
aorta.

Question 4

During thee ventricular systole the aorta receives?

Answer 4

During the ventricular systole the aorta receives an amount of blood increased by the volume which
regurgitated into the left ventricle during systole.

Question 5

The blood in aorta flows in?

Answer 5

The blood in aorta thus flows in two directions during diastole. Via the incompletely closed aortic
valve the ”excessive” volume of blood returns into the left ventricle and the periphery receives a
normal amount of blood. The volume which in consequence of aortic insufficiency returns into the
left ventricle moves therefore pendulously between the left ventricle and aorta.

Question 6

Alterations?

Answer 6

The presented alterations result in increased amount of blood in the left ventricle at the end of
diastole. In consequence of volume overload the internal volume of the ventricle increases and the
ventricular wall less markedly thickens.
Hypertrophy of the volume type – excentric hypertrophy develops which
compensates the volume overload for a long period (10–30 years).
The hypertrophic left ventricle reaches enourmous size
and weight of 700–1000 grams. The working capacity of the heart markedly increases.

Question 7

The pressure conditions in the left ventricle depend on ?

Answer 7

1.regurgitation,
2.state of ventricular
musculature and
3.frequency of contractions.

Question 8

Size of regurgitated volume depends on?

Answer 8

1.The size of regurgitated volume depends on the severity of the valvular defect. In addition to
that the regurgitation increases parallelly with the increase of arterial pressure.

Question 9

Left ventricular wall hypertrophy does?

Answer 9

2. The left ventricular wall hypertrophy itself deteriorates the elastic properties and at the given
   end- diastolic volume the ventricular pressure thud increases.

Question 10

3.?

Answer 10

3. The increased frequency shortens the whole cardiac cycle, and especially the diastole.
   Tachycardia thus restricts regurgitation and decreases the diastolic pressure. In this disease
   tachycardia may act as a certain compensatory mechanism.