Aortic Atherosclerosis: How Symptoms Like Head Heaviness and Brain Ringing Can Be Warning Signs
When it comes to cardiovascular health, symptoms like head heaviness and brain ringing are often overlooked. However, these can sometimes indicate a more serious underlying condition such as aortic atherosclerosis. In this case study, we explore how a 78-year-old patient presented with these unusual symptoms and was later diagnosed with severe aortic narrowing due to atherosclerosis.
Case Overview
This case involves a 78-year-old female patient who visited our hospital due to persistent head heaviness and a constant ringing sensation in her brain. She had experienced similar symptoms two days prior, but they had resolved on their own. This time, however, the symptoms lingered, prompting her to seek medical attention. After a series of diagnostic tests, including physical examination and X-ray imaging, she was diagnosed with aortic atherosclerosis. The condition had progressed to the point of significant aortic stenosis, which required immediate intervention. Following an arterial stent procedure and medication therapy, her condition stabilized and her symptoms resolved.
Patient Profile
- Age: 78 years old
- Gender: Female
- Diagnosis: Aortic atherosclerosis
- Hospital: First Affiliated Hospital of Xi'an Jiaotong University
- Visit Date: February 2021
- Treatment Plan: Arterial stent surgery, intravenous antibiotics (Cefoperazone Sodium and Sulbactam Sodium for injection), oral medications (Atorvastatin Calcium and Nifedipine)
- Recovery: Five-day hospitalization followed by monthly check-ups
- Outcome: Complete resolution of symptoms and improved aortic blood flow
Initial Consultation
The patient arrived at the clinic accompanied by her family. She reported experiencing head heaviness and a persistent ringing in her head upon waking two days earlier. This time, the symptoms had returned and were not subsiding. She also had a history of coronary artery disease, hypertension, hyperlipidemia, and chronic obstructive pulmonary disease (COPD). Upon examination, her blood pressure was significantly elevated with a wide pulse pressure, indicating stage 3 hypertension. Given her symptoms and medical history, we suspected severe aortic stenosis. Emergency X-ray scans confirmed aortic calcification and significant arterial narrowing, which could lead to inadequate cerebral blood flow and the symptoms she was experiencing. Based on these findings, she was admitted to the hospital for further treatment under the diagnosis of aortic atherosclerosis.
Treatment Process
After confirming the diagnosis of aortic atherosclerosis, we discussed the treatment plan with the patient and her family. They agreed to proceed with an arterial stent procedure. Preoperative preparations included skin preparation, sterilization, and anesthesia. During the surgery, the incision site was determined based on angiography results. Arterial puncture was performed, and an arterial sheath was inserted. Using the sheath, a contrast catheter and guidewire were introduced into the aorta. Once the narrowed segment was identified, a guiding catheter and guidewire were used to precisely place the stent at the site of stenosis.
Postoperatively, the patient was given intravenous Cefoperazone Sodium and Sulbactam Sodium to prevent surgical site infection. Due to her existing conditions of hyperlipidemia and hypertension, she was prescribed Atorvastatin Calcium to manage cholesterol levels and Nifedipine to control blood pressure. These medications are essential in preventing the progression of atherosclerosis. For her COPD, she was advised to consult with a pulmonologist after completing her current recovery phase.
Treatment Outcomes
Following the stent placement and postoperative care, the patient reported that her symptoms of head heaviness and brain ringing had disappeared. Her blood pressure returned to normal levels during follow-up examinations. X-ray imaging confirmed that the aortic narrowing had been successfully resolved. After a 5-day hospital stay, her surgical wound healed completely, and she was discharged. During monthly follow-up visits, X-rays showed no progression of aortic atherosclerosis, and the patient reported feeling well overall.
Post-Discharge Recommendations
While the surgical intervention successfully corrected the aortic narrowing, long-term management is crucial for maintaining cardiovascular health. The patient was advised to continue taking Atorvastatin Calcium and Nifedipine as prescribed to control lipid levels and blood pressure. Dietary modifications were also emphasized, including avoiding high-fat and high-sodium foods to reduce the risk of disease recurrence.
Given her age and slower post-anesthesia recovery, she was encouraged to consume easily digestible foods such as rice porridge and pumpkin soup to ease gastrointestinal strain. Any new or worsening symptoms were to be reported immediately to her healthcare provider to ensure timely intervention and prevent complications.
Clinical Insights
This case highlights the importance of recognizing non-specific symptoms like head heaviness and brain ringing as potential indicators of serious cardiovascular conditions such as aortic atherosclerosis. Early diagnosis and intervention were key in preventing further complications such as stroke or cognitive decline due to chronic cerebral hypoperfusion.
The patient's underlying conditions—hypertension and hyperlipidemia—were likely contributing factors to the progression of atherosclerosis. Lifestyle and dietary changes, along with consistent medical management, are essential in preventing recurrence and maintaining long-term health. This case also underscores the importance of prompt medical attention when unusual symptoms arise, especially in elderly patients with multiple comorbidities.