Stenosis is a medical term that comes from Latin (stenosis). Stenosis is a general term that means the stenosis of an organ. Therefore, stenosis is not a specific disease as it can affect many organs in our body. In Polish, the term stenosis has been adopted primarily to refer to the heart valves, spinal canal, arterial vessels and some parts of the gastrointestinal tract. Stenosis of each of these organs is a separate disease entity, which differs in course, symptoms and treatment method. Find out what the most common types of stenosis are, how stenosis manifests itself and how it is treated.
Stenosis , or stricture, may affect many organs of our body. The term stenosis in Latin is used to refer to most organs with a tubular structure: the respiratory tract, digestive tract, ureters or blood vessels. Each of these organs has a lumen, which may be narrowed under disease conditions. In Polish, the term stenosis is used for just a few organs.
Stenosis - what is it?
The term "stenosis" is most often encountered in relation to cardiological diseases - stenosis is referred to in the context of heart valves. The human heart has four valves:
- two-way,
- threefold,
- pulmonary
- and aortic.
Each valve may be pathologically narrowed. There are therefore four possible types of stenosis in relation to our heart, corresponding to the narrowing of each valve. The most common of these is aortic stenosis, which is the third most common heart disease (after hypertension and ischemic heart disease).
The concept of stenosis can also be found in other branches of medicine - orthopedics, gastrology and angiology. Examples of diseases, the essence of which is the narrowing of an organ, are:
- spinal stenosis,
- pyloric stenosis
- whether arterial stenosis.
These diseases concern completely different locations in our body, so despite the common element - stenosis, their clinical course is different.
Stenosis can be both congenital and acquired.Congenital organ stenosisstems most often fromabnormal organ development during fetal life. An example of such a condition is pyloric stenosis (the end of the stomach). This type of stenosis is usually detected during childhood.
Acquired stenosisis most often a consequence of a chronic disease process and typically occurs in adults. For example, stenosis of heart valves may be a congenital defect, but it is more often acquired in nature.
Stenosis - the most common forms
Although the term stenosis can be used to describe stenosis of many organs, in practice it is found in the name of several specific diseases. Here are the characteristics, symptoms, and treatments for the most common types of stenosis:
Aortic Stenosis
Aortic stenosis is a disease whose essence is the narrowing of the aortic valve. The aortic valve is a small structure located in the heart. The aortic valve separates the left ventricle from the aorta - the largest artery in our body.
The main role of the aortic valve is to prevent the blood from flowing back from the aorta to the heart as it relaxes. In a he althy body, when the heart contracts, the aortic valve opens and the heart pumps blood to the aorta.
Aortic stenosis is a narrowing of the surface of the aortic valve. While stenosis can also occur in other heart valves, aortic stenosis is by far the most common of these.
What are the effects of aortic stenosis?Valve stenosis significantly obstructs blood flow from the heart to the aorta. With aortic stenosis, the heart must build up much higher pressure in order to continue pumping blood. The heart becomes overloaded then - blood remains in its chambers and cannot enter the aorta and other arteries. In this way, the right amount of blood cannot go to the rest of the body's organs. Fainting (due to temporary cerebral ischemia) and chest pains appear. Other symptoms of aortic stenosis include palpitations and general weakness.
The most commoncause of aortic stenosisj is degeneration that progresses with age. In the population of people over 75 years of age, the incidence of aortic stenosis is as high as 5%. Minor aortic stenosis may not cause any symptoms - then it only requires regular control by echocardiography of the heart (the so-called ECHO of the heart).
Severe aortic stenosis, causing clinical symptoms, is an indication for aortic valve replacement.
Mitral Stenosis
Mitral stenosis is another example of a disease whose essence is the narrowing of one of the heart valves. Mitral valve, also calledbipartite, occurs in the left part of the heart and separates the left atrium from the left ventricle. Unlike aortic stenosis, which mainly occurs in elderly people, mitral stenosis often affects younger patients as well.
The most common cause of mitral stenosis is rheumatic fever. Rheumatic fever is a disease caused by streptococci and occurs most frequently in children. One of the common complications is mitral valve involvement. Due to the availability of antibiotics, such complications are now much less common than in the past.
Mitral stenosis, or stenosis of the mitral valve, obstructs the flow of blood from the left atrium to the left ventricle. The residual blood in the left atrium causes its significant enlargement. If blood is not pumped efficiently through the heart, it is in the pulmonary circulation. Typical shortness of breath and coughing appears. At the same time, insufficient blood goes to the other organs, which causes general weakness.
Minor mitral stenosis is treated pharmacologically with medication for heart failure. In the case of severe mitral stenosis, two types of procedures are used: dilating the valve with a special balloon or its complete replacement.
Spinal canal stenosis
The spinal canal is the space inside your spine where the spinal cord runs. Stenosis of the spinal canal, i.e. its narrowing, can cause compression of the nerve structures located in it. S
spinal tenosis can occur in different parts of the spine:
- cervical,
- pectoral,
- lumbar
- or cross.
Depending on the location of the stenosis, spinal stenosis will cause a variety of symptoms. Cervical spinal stenosis causes discomfort in the upper limb. There are pain in the shoulder and arm, muscle weakness or difficulty in making precise hand movements.
The symptom of spinal stenosis in the cervical region can also be unpleasant tingling and numbness in the hand.
Lumbar stenosis causes similar ailments, however, they affect the lower limbs and buttocks. The pain in lumbar stenosis resembles sciatica - it radiates from the lumbar spine towards the fossa.
In turn, stenosis of the end (sacral) section of the spine can cause disorders of the sphincters as well as problems with urination and stools.
There are many possible causes of spinal stenosis:
- osteoarthritis of the spine,
- discopathy,
- inflammatory diseasesspine,
- as well as neoplastic processes.
In the initial stages of spinal stenosis, conservative methods of treatment (rehabilitation, pharmacotherapy) are used. However, if the underlying stenosis of the spinal canal are permanent anatomical changes, the best results are achieved by surgical treatment of the spine.
Pyloric stenosis
Pyloric stenosis is an example of congenital organ stenosis. The pylorus is the end of the stomach that connects it to the small intestine. Pyloric stenosis is an overgrowth and narrowing of the pylorus, which prevents food from moving from the stomach to other parts of the digestive tract.
Pyloric stenosis usually shows symptoms in the first weeks of a baby's life. The first to appear is vomiting, the frequency of which is gradually increasing. In advanced pyloric stenosis, vomiting occurs after each feed.
Vomiting is violent, "splashing", additionally accompanied by the constant hunger of the child.
The diagnosis of pyloric stenosis can be made by ultrasound examination (USG) of the abdominal cavity.
The treatment of the disease involves surgical incision and widening of the pylorus. In most cases, the treatment allows for a complete recovery.
Artery stenosis
Vascular stenosis can affect all arteries in our body. By far the most common cause of arterial stenosis is atherosclerosis. Atherosclerotic plaques in the vessel walls are caused by many factors:
- improper diet,
- high cholesterol,
- too little physical activity,
- smoking,
- as well as genetic factors.
Atherosclerosis leads to gradual narrowing, i.e. stenosis of blood vessels. The most serious effects concern stenosis of the carotid and coronary arteries. The carotid arteries carry blood to the brain, therefore their significant narrowing carries the risk of ischemic stroke. Coronary arteries, on the other hand, are responsible for the blood supply to the heart muscle.
Coronary artery stenosis causes ischemic heart disease, which in its advanced form may cause a heart attack. Arterial stenosis relatively often also affects the arteries of the lower extremities.
A characteristic symptom of lower limb artery stenosis is pain in the legs and calves, appearing while walking. It is worth remembering that arterial stenosis is a disease in which prevention plays a huge role.
A he althy lifestyle, regular physical activity, a diet low in saturated fat, and avoiding addiction can significantly slow down your progressatherosclerosis.
In the case of advanced arterial stenosis, various procedures are used to widen their lumen (removal of atherosclerotic plaques, the so-called "ballooning" or stenting).