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A stenosis ( Greek στένωσις sténosis , German 'constriction' ) is a narrowing or narrowing (of the lumen) or constriction (narrowed point) of hollow organs (for example of blood vessels , the trachea or the ureter). Causes , symptoms , diagnosis and treatment depend on the localization and clinical findings . When stenosis is the process of contraction.

Stenosis of the blood vessels

Stenosis in the common carotid artery on ultrasound . The flow rate is increased in the stenosis.

Stenoses of the blood vessels are mostly caused by arteriosclerosis , but can also result from injuries or inflammation or be congenital.

With restenosis of the re-closure of the blood vessel is referred to after treatment. This is a common complication after the insertion of a stent , for example , when the body's own tissue grows into the vessel and thereby narrows it again.

In coronary heart disease (CHD), a stenosis often manifests itself in anginal symptoms. A stenosis is often the preliminary stage of an obstruction that then leads to an acute heart attack .

If there are stenoses in the arterial leg vessels, one speaks of peripheral arterial occlusive disease . There are also stenoses of the renal arteries ( renal artery stenosis ), the iliac vessels and the neck vessels ( carotid stenosis ). The latter pose a risk of cerebral infarction due to vascular occlusion or arterial embolism .

For diagnosis, sonography or stress echocardiography , digital subtraction angiography or coronary angiography , magnetic resonance angiography and computed tomography angiography are used.

Often, only drug treatment is indicated , in which blood pressure , triglycerides and cholesterol are lowered and anticoagulants are given. However, there are also indications in which stenoses are treated with angioplasty (with or without stenting ) or with a bypass . For the coronary vessels , these procedures are called PTCA (also balloon dilatation ) or coronary artery bypass .

Stenoses of the heart valves

As aortic stenosis which is congenital or acquired narrowing of the aortic valve , or (as in the aortic coarctation understood) of the outflow tract of the left ventricle. Stenoses also occur in other heart valves , especially in the area of ​​the pulmonary valve ; the atrioventricular valves ( mitral valve and tricuspid valve ) are less often affected. During auscultation, stenoses are characterized by an increasing and decreasing heart murmur (crescendo- decrescendo type).

Further stenoses

See also

Individual evidence

  1. Duden: Narrowing .
  2. Duden: Narrowing .
  3. ^ JO Gebbers: Atherosclerosis, cholesterol, nutrition, and statins - a critical review GMS Ger Med Sci. 2007; 5; Doc04 .
  4. G. Herold: Internal Medicine. Herold-Verlag, Cologne 2009.