Short stature (synonyms: short stature, short stature; microsomia, dwarfism; ICD-10-GM E34.3: Short stature, not elsewhere classified; ICD-10-GM Q87.1: Congenital malformation syndromes predominantly associated with short stature) is a term used to describe a lower than normal growth in body length (below the 3rd percentile). Short stature usually occurs as a result of decreased growth rate … Short Stature
The following symptoms and complaints may indicate heart vitias (heart valve defects): Aoten valve Aortic stenosis Usually symptom-free for a long time Limited performance Fatigue Dyspnea (shortness of breath) Angina pectoris (“chest tightness”; sudden pain in the region of the heart) Dizziness Syncope (momentary loss of consciousness) Aortic insufficiency Palpitations (heart palpitations, heart stuttering) Cardiac … Valvular Heart Disease: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The human heart is composed of two systems (left and right hearts), each consisting of an atrium (atrium cordis) and a ventricle (ventricle). Between the left atrium (atrium cordis sinistrum) and the left ventricle is the mitral valve as the inlet valve, and as the outlet valve from the ventricle is … Valvular Heart Disease: Causes
General measures The following also applies to children with congenital heart defects: at least 1 hour of physical activity daily!A study was able to show that physical activity is often restricted on medical advice; there is thus an urgent need for action here.For information on exercise, see the respective heart valve defects. During pregnancy, the … Valvular Heart Disease: Therapy
Heart valve defects (HKF) can be classified into the following severity levels according to the New York Heart Association (NYHA): NYHA Complaint level I No complaints II Complaints during heavy exertion III Complaints during light exertion IV Complaints at rest Aortic valve stenosis can be classified as follows: Grade KÖF* (cm²) KÖF/body surface (cm²/m²) Mean … Valvular Heart Disease: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [cyanosis (bluish discoloration of the skin and/or central mucous membranes caused by a lack of oxygen)] Neck vein congestion? … Valvular Heart Disease: Examination
2nd-order laboratory parameters-depending on the results of the history and physical examination-for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Fasting glucose (fasting blood glucose). Blood gas analysis (BGA) High-sensitivity cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – for suspected myocardial infarction (heart attack). NT-proBNP … Valvular Heart Disease: Test and Diagnosis
Therapeutic target Improvement in exercise capacity Therapy recommendations Aortic stenosis (drug therapy is not possible). Aortic insufficiency: ACE inhibitors, angiotension II receptor antagonists (to lower preload and afterload* ). Cardiac glycosides (to increase contractility). Diuretics Mitral stenosis: Cardiac glycosides (for atrial fibrillation; to increase contractility/ability to contract). Diuretics (diuretic medications). Mitral regurgitation: Endocarditis prophylaxis (preventive … Valvular Heart Disease: Drug Therapy
Obligatory medical device diagnostics. Electrocardiogram1-5 (ECG; recording of the electrical activity of the heart muscle). Echocardiography1-5 (echo; cardiac ultrasound) including color Doppler – for localization and quantification of valvular insufficiencies and stenosesSevere aortic stenosis according to ESC (European Society of Cardiology) and ACC/AHA (American College of Cardiology/American Heart Association). Vpeak ≥ 4 m/s, Mean pressure … Valvular Heart Disease: Diagnostic Tests
Aortic valve Aortic valve stenosis (aortic stenosis). Indication for aortic valve replacement (ACE): Presence of criteria for severe aortic valve stenosis (see below for medical device diagnosis/echocardiography) + patient is symptomatic or has left ventricular systolic dysfunction with an LVEF (left ventricular ejection fraction/volume) <50 Asymptomatic severe aortic stenosis (5-year cumulative incidence of sudden cardiac … Valvular Heart Disease: Surgical Therapy
To prevent cardiac ventricular disease (valvular heart disease), attention must be paid to reducing individual risk factors. Behavioral risk factors Overweight (BMI ≥ 25; obesity)1 Android body fat distribution1, that is, abdominal/visceral, truncal, central body fat (apple type) – high waist circumference or waist-to-hip ratio (THQ; waist-to-hip ratio (WHR)) is presentWhen waist circumference is measured … Valvular Heart Disease: Prevention
