С.Д.АСФЕНДИЯРОВ АТЫНДАҒЫ ҚАЗАҚ ҰЛТТЫҚ МЕДИЦИНА УНИВЕРСИТЕТІ КАЗАХСКИЙ НАЦИОНАЛЬНЫЙ МЕДИЦИНСКИЙ УНИВЕРСИТЕТ ИМЕНИ С.Д.АСФЕНДИЯРОВА 1 ІШКІ АУРУЛАР КАФЕДРАСЫ Performed: Assil Akmaral GM k Checked: Kalieva K.B. Theme: Aortic stenosis.

25 years old man complains on: compressive pains on the chest(do not irradiate); weakness; dyspnea; dizziness. 25 years old man complains on: compressive pains on the chest(do not irradiate); weakness; dyspnea; dizziness. COMPLAINTS

Thinks himself sick for 1 month. He fell at work in a faint month ago. Associated deterioration of state of health with increased physical exertion. After there was shortness of breath with moderate physical exertion and tachycardia. ANAMNESIS MORBI

He was born in 1992 on 25 th of September in Almaty. Allergic anamnesis: no allergy. Profession: office worker. Heredity: arterial hypertension on his mother. Blood transfusion was not performed, he did not suffer from hepatitis, tuberculosis, HIV. Bad habits: he smokes for 8 years, but doesnt drink. He was born in 1992 on 25 th of September in Almaty. Allergic anamnesis: no allergy. Profession: office worker. Heredity: arterial hypertension on his mother. Blood transfusion was not performed, he did not suffer from hepatitis, tuberculosis, HIV. Bad habits: he smokes for 8 years, but doesnt drink. ANAMNESIS VITAE

Consciousness is clear. Height cm, weight - 69 kg. Normostenik. Skin pale, moderate acrocyanosis. In the lungs vesicular breathing, single inconspicuous finely bubbling rales in the lower parts. RDA of 24 per minute. The apical thrust is diffuse, high. The heart sounds are muffled, the rhythm is correct, the tone II is weakened on the aorta, the systolic murmur in the 2nd intercostal space on the right is carried on the vessels of the neck. Blood pressure 100/70 mm Hg, heart rate 80 per min. Liver at the edge of the costal arch. OBJECTIVE EXAMINATION

General blood analysis: General urine analysis: Biochemical analysis: Erythrocytes – 4,5 х 10^12 /l; hemoglobin – 152 g/l; Leukocytes – 5,5 х 10^9 /l; с / я – 68%; т / я – 2%; Eosinophils– 3%; Lymphocytes – 24%; Monocytes – 5%; Р latelets – 250 х 10^9 /l; ESR – 18 mm/hour Volume – 100 ml; specific gravity– 1022; Colour – yellow; Leukocytes – 2-3; Erythrocyres – 1-2. ALT – 18 Ed/ l; AST – 14 Ed/ l; Glucose – 4,5 mmol/l; Cholesterol – 5,9 mmol/l; Triglycerides– 2,3 mmol/l; Creatinine– 92 mcmol/l; Urea– 6,0 mcmol/l.

Conclusion: Systolic deflection of valve flaps in the direction of the aorta, expressed calcification of the valves of the aortic valve and the root of the aorta. Severe myocardial hypertrophy of the left ventricle, an increase in the thickness of the IVF and the posterior wall of the left ventricle.

Conclusion: "Aortic" configuration of the shadow of the heart ("sedentary duck") - left ventricular hypertrophy

ECG conclusion: EOS shifted to the left, hypertrophy of the LV, systolic overload, T negative. ECG conclusion: EOS shifted to the left, hypertrophy of the LV, systolic overload, T negative.

QUESTIONS: 1.What is a clinical diagnosis? 2.What is syncope? 3.Prescribe the right treatment.

DIAGNOSIS: Chronic rheumatic heart disease. Stenosis of the aortic aperture (aortic stenosis). Chronic heart failure ІІА, FC 3.

Syncope, also known as fainting, is defined as a short loss of consciousness and muscle strength, characterized by a fast onset, short duration, and spontaneous recovery. It is due to a decrease in blood flow to the entire brain usually from low blood pressure. SYNCOPE is:

In general, medical therapy has relatively poor efficacy in treating aortic stenosis. However, it may be useful to manage commonly coexisting conditions that correlate with aortic stenosis. Treatment is surgical. Patient preparation for the operation: antibiotic therapy, anti-inflammatory therapy and cardiometabolics. In general, medical therapy has relatively poor efficacy in treating aortic stenosis. However, it may be useful to manage commonly coexisting conditions that correlate with aortic stenosis. Treatment is surgical. Patient preparation for the operation: antibiotic therapy, anti-inflammatory therapy and cardiometabolics. TREATMENT: