Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)1990-472XФедеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации784110.18499/1990-472X-2022-0-88-86-92Original ArticleBIVALVE AORTIC VALVE AS RISK FACTOR FOR ISCHEMIC STROKE: EFFECTIVE REHABILITATION METHODSZhemchuzhnikovaA. A-District hospital of the city of Liski2809202288869227092022Copyright © 2022, Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)2022Acute cerebrovascular accident (ONMC) is still one of the leading causes of mortality and disability among all nosological diseases. Ischemic stroke (AI) may be the first clinical manifestation of a cardioembolic variant in cardiovascular pathology (CCC). Cardiac embolism accounts for about 1/4 of AI. Strokes due to cardioembolism are usually severe and are prone to early and distant relapses. Cardioembolism can be suspected by clinical signs, but is often difficult to diagnose. Magnetic resonance imaging (MRI), transcranial dopplerography, echocardiogram, Holter and electrophysiological studies can help establish the source of cardioembolism. The bicuspid aortic valve (DAK) is by far the most common congenital heart disease (PRS). Remaining asymptomatic for a long time, it can eventually be complicated by the development of aortic stenosis or aortic insufficiency. DAC is also associated with aortic aneurysm and its dissection. Given the high prevalence of this defect and the severity of the complications, it is believed to be responsible for more deaths than all other congenital heart defects combined. Therefore, it is relevant to determine the characteristics of patient management taking into account comorbid pathology and the formation of a multi-disciplinary team (MDB) for an individual approach to the rehabilitation and treatment of patients with DAK. The article details the clinical case of a 47-year-old patient with AI and newly diagnosed DAK in the absence of obvious clinical signs of heart disease. The importance of routine assessment of cardioembolic sources of all AI development options is emphasized. As well as detailed consideration of the modern possibilities of conservative treatment of AI and effective rehabilitation methods.congenital heart diseasebicuspid aortic valveischemic strokerehabilitationthrombolytic therapyврожденный порок сердцадвустворчатый аортальный клапанишемический инсультреабилитациятромболитическая терапия1.Клинические рекомендации «Ишемический инсульт и транзиторная ишемическая атака у взрослых» https://cr.minzdrav.gov.ru/recomend/171_2 @@ Clinical Guidelines "Ischemic Stroke and Transient Ischemic Attack in Adults https://cr.minzdrav.gov.ru/recomend/171_2"2.Носенко Н.Н. Кардиологическая патология у пациентов с острым нарушением мозгового кровообращения: особенности лечения и профилактика осложнений / Н.Н. Носенко, Д.В. Щеглов, М.Ю. Мамонова // Ендоваскулярна нейрорентгенохірургія. - 2017. - № 3(21). - С. 93-105. @@Nosenko N.N. Cardiological pathology in patients with acute cerebrovascular accident: peculiarities of treatment and prevention of complications/N.N. Nosenko, D.V. Scheglov, M.Yu. Mamonova//Endovascular neyrorentgenokhіrurgіya. - 2017. - № 3(21). - S. 93-105.3.Куташов В.А. Редкое неврологическое заболевание, приводящее к нарушению мозгового кровообращения / В.А. Куташов, О.В. Ульянова // Саратовский научно-медицинский журнал. - 2020. - Т. 16, № 1. - С. 360 - 363. @@Kutashov V.A. A rare neurological disease leading to cerebrovascular accident/V.A. Kutashov, O.V. Ulyanova//Saratov Scientific and Medical Journal. - 2020. - T. 16, No. 1. - S. 360 - 363.4.Влияние изменений гомеостатических констант показателей крови у больных с кардиоэмболическим инсультом на клиническое течение и прогноз заболевания / О.Н. Хаханова, А.П. Скороходов, В.А. Куташов, О.В. Ульянова // Саратовский научно-медицинский журнал. - 2020. - Т. 16. - № 1. - С. 384-388. @@The effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke on the clinical course and prognosis of the disease/ON Khakhanova, A.P. Skorokhodov, V.A. Kutashov, O.V. Ulyanova//Saratov Scientific and Medical Journal. - 2020. - T. 16. - № 1. - S. 384-388.5.Ульянова О.В. Новая коронавирусная инфекция (COVID-19) как фактор цереброваскулярных рисков / О.В. Ульянова, И.В. Шарова, С.Ф. Чевычалов // Научно-медицинский вестник Центрального Черноземья. - 2021. - № 86. - С. 50-55. @@Ulyanova O.V. New coronavirus infection (COVID-19) as a factor of cerebrovascular risks/O.V. Ulyanova, I.V. Sharova, S.F. Chevychalov//Scientific and Medical Bulletin of the Central Black Earth Region. - 2021. - № 86. - S. 50-55.6.Неврологические и психические проявления у пациентов с ишемическим инсультом мозжечка в раннем и позднем восстановительном периодах / О.В. Ульянова, В.А. Куташов, В.А. Вербенко [и др.] // Вестник неврологии, психиатрии и нейрохирургии. - 2018. - № 6. - С. 40-44. @@Neurological and mental manifestations in patients with ischemic cerebellar stroke in the early and late restorative periods/O.V. Ulyanova, V.A. Kutashov, V.A. Verbenko [et al. ]//Bulletin of Neurology, Psychiatry and Neurosurgery. - 2018. - № 6. - S. 40-44.7.Куташов В.А. Наиболее значимые предикторы кардиоэмболического инсульта, определяющие клиническую картину и исход заболевания / В.А. Куташов, О.В. Ульянова // Вестник неврологии, психиатрии и нейрохирургии. - 2016. - № 6. - С. 54-58. @@Kutashov V.A. The most significant predictors of cardioembolic stroke, determining the clinical picture and outcome of the disease/V.A. Kutashov, O.V. Ulyanova//Bulletin of Neurology, Psychiatry and Neurosurgery. - 2016. - № 6. - S. 54-58.8.Куташов В.А. Наследственные заболевания в практике врача невролога / В.А. Куташов, О.В. Ульянова // Прикладные информационные аспекты медицины. - 2020. - Т. 23. - № 1. - С. 35-41. - EDN PSOOTZ. @@Kutashov V.A. Hereditary diseases in the practice of a neurologist/V.A. Kutashov, O.V. Ulyanova//Applied information aspects of medicine. - 2020. - T. 23. - № 1. - S. 35-41. - EDN PSOOTZ.9.Ntaios G, Papavasileiou V, Milionis H, Makaritsis K, Manios E, Spengos K, Michel P, Vemmos K. Embolic strokes of undetermined source in the Athens stroke registry: a descriptive analysis. Stroke. 2015. - 46(1). - Р. 176-81. doi: 10.1161/STROKEAHA.114.007240.10.Suryaprabha T, Kaul S, Alladi S, Bandaru VS, Singh A. Acute posterior circulation infarct due to bicuspid aortic valve vegetation: An uncommon stroke mechanism. Ann Indian Acad Neurol. 2013. - 16(1). - Р. 100-2. doi: 10.4103/0972-2327.107713.11.Martín M, Lorca R, Rozado J, Alvarez-Cabo R, Calvo J, Pascual I, Cigarrán H, Rodríguez I, Morís C. Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity. J Thorac Dis. 2017 May;9(Suppl 6):S454-S464. doi: 10.21037/jtd.2017.05.11. PMID: 28616342; PMCID: PMC5462719.12.Sun BJ, Song JK. Bicuspid aortic valve: evolving knowledge and new questions. Heart. 2022: heartjnl-2021-320008. doi: 10.1136/heartjnl-2021-320008. Epub ahead of print. PMID: 35264416.13.Diener HC, Chutinet A, Easton JD, Granger CB, Kleine E, Marquardt L, Meyerhoff J, Zini A, Sacco RL. Dabigatran or Aspirin After Embolic Stroke of Undetermined Source in Patients With Patent Foramen Ovale: Results From RE-SPECT ESUS. Stroke. 2021. - 52(3). - Р. 1065-1068. doi: 10.1161/STROKEAHA.120.031237.14.Ntaios G. Embolic Stroke of Undetermined Source: JACC Review Topic of the Week. J Am Coll Cardiol. 2020. - № 75(3). - Р. 333-340. doi: 10.1016/j.jacc.2019.11.024.