Laboratory Findings
Posted by admin on November 25th, 2009Cardiac enlargement with a dilated aorta and occasionally an aorlie aneurysm is characteristic on chest x-ray. Linear calcification of the ascending aorta is typical in syphilitic aortic regurgitation. This con¬trasts with the x-ray findings of benign aortic calcification. The ECU shows left ventricular hyperlrophy. On echocardiography, Ihe left ven¬tricular cavity is enlarged, often with early diastolic fluttering of ihe anterior mitral valve leaflet. Enlarging ventricular dimensions and evi¬dence of ventricular dysfunction in the symptomatic patient arc indica¬tions for surgery-Treatment
Medical management is the same as thai for heart failure and includes sodium restriction, diuretic and vasodilator therapy, and at times, digi¬talis. Drugs that cause bradycardia should be avoided, because relative diastolic prolongation can increase the regurgitation and accentuate symptoms. Patients who remain symptomatic after receiving optimal medical therapy should be considered for valve replacement; the re-sults are less satisfactory than in patients wilh aortic stenosis because of frequent severe underlying ventricular dysfunction. Bioprosthetic valves are favored because (hey do not require anticoagulant therapy. which may be associated with higher risk of bleeding in Ihe elderly
