Combined aortic Vice

In rheumatoid arthritis may be a combination of the failure of the aortic valve stenosis aortic. Hemodynamics this combination is suffering much more than isolated aortic vices. In the clinical picture the combined aortic insufficiency with stenosis aortic summarized the symptoms of one and another wrinkle. Along with diastolic noise aortic insufficiency systolic murmur of aortic stenosis. Percutere is defined distinct extension left the borders of relative cardiac dullness left and down due to dilation and hypertrophy of the left ventricle. The apical jerk is strengthened, shifted to the left and down.
In deciding on the prevalence of symptoms of failure or stenosis of great importance peripheral symptoms. Pulse-type celer et altus, a large pulse pressure is usually observed at the prevalence of deficiency of the aortic valve, and low pulse pressure is often a sign of dominance of the stenosis. Help in the diagnosis of combined aortic blemish data of x-ray examination (Fig. 24), as well as electrical and phonocardiographic signs (Fig. 25).
Compensation when combined aortic disease can last a long time. Decompensated primarily develop congestion in the lungs, this is manifested clinically by shortness of breath, persistent wheezing. The terminal period of the disease revealed signs of stagnation in the pulmonary circulation (enlargement of the liver, swelling).

Fig. 24. Chest x-ray of the patient P., 14 years.
Clinical diagnosis: rheumatism. Inactive phase. Combined aortic flaw with predominance of failure aortic valve H2a.
a - front projection. Heart sharply increased in diameter. Expressed congestion in the lungs; b - the left-side projection. Significantly enlarged left atrium and left ventricle. There was an increase in the right ventricle.