Decker Jamie A
Division of Pediatric Cardiology,All Children's Heart Institute,Saint Petersburg,Florida,United States of America.
Cardiol Young. 2014 Dec;24(6):1064-70. doi: 10.1017/S1047951114001978.
Valvar heart disease can be complicated by hemodynamic derangements, depending on the degree of the abnormality. Stenosis causes pressure overload of the chamber draining through the valve and regurgitation results in volume overload. Many lesions have a component of both, resulting in both pressure and volume overload. Increased wall stress causes myocardial stretching and fibrosis, resulting in scarring; a nidus for arrhythmia development. Arrhythmias can complicate the clinical picture and increase the morbidity and mortality in patients with both congenital and acquired valvar disease. In adults with congenital heart disease, arrhythmias are the most common cause of sudden death, followed by heart failure. Valvar stenosis and insufficiency certainly contribute to this. This article highlights the need for arrhythmia surveillance for high-risk valvar lesions.
瓣膜性心脏病可能会因血流动力学紊乱而变得复杂，这取决于异常的程度。狭窄会导致通过瓣膜引流的腔室压力过载，而反流则会导致容量过载。许多病变同时具有这两种成分，导致压力和容量均过载。增加的壁应力会导致心肌拉伸和纤维化，进而形成瘢痕；这是心律失常发生的病灶。心律失常会使临床情况变得复杂，并增加先天性和后天性瓣膜病患者的发病率和死亡率。在患有先天性心脏病的成年人中，心律失常是猝死的最常见原因，其次是心力衰竭。瓣膜狭窄和关闭不全肯定对此有影响。本文强调了对高危瓣膜病变进行心律失常监测的必要性。
