heart defect in which blood in reducing due to incomplete closure moving in the opposite direction from the left ventricle into the left atrium. This is one of the most frequent cardiac valvular. Found disease half of patients with heart disease. It usually is accompanied by mitral stenosis and insufficiency of aortic valves, and rarely acts as an independent pathology (2% of cases).
Mitral insufficiency in children quite often. With age, some patients who showed slight or moderate degree of disease, they grow it decreases retrograde blood flow up to normalization.
Disease klassificeret depending on several factors temporary, speed and power
- time congenital (mixomatosis denegrate, anomalies in the structure of the mitral valve, a feature of the structure of the chords) or acquired (associated with organic changes in the valve leaflets and inorganic is not related to changes in the structure of the valve)
- the rate of development of acute and chronic
- because the organic and functional, or relative mitral insufficiency
- severity mitral regurgitation of 1 degree, 2 degrees, 3 degrees, 4 degrees.
Congenital mitral valve insufficiency phenomenon is quite frequent. It develops in the fetus due to effects on the body of the mother of adverse factors. It can be an infection, x-ray or radiation irradiation, etc.
Quite a lot of reasons for the development of acquired forms of pathology. First of all, it
(then marvel and other valves), infectious
closed heart injury, surgical treatment of mitral stenosis.
Acquired functional or relative form of the disease these risk factors are acute
in which there is a loss of papillary muscle, rupture of chords. Deficiency leads to and expansion of the fibrous ring, located inside the machine heart. It, in turn, is due to
increase of the left ventricle due to
and disorders of blood flow caused by stenosis or tumor.
Prominent symptom of mitral regurgitation is a cough. It may be accompanied by sputum with the content in it streaks of blood. Cough appears with the growth of stagnation of blood in the blood vessels of the lungs. For the same reason shortness of breath.
Of failure shows rapid heartbeat, fading or irregularity. Felt coups in the left half of the sternum. The patient weakens, the efficiency decreases, due to the disturbed distribution of blood in the body.
The skin of such a patient is characterized by cyanosis (cyanosis), on the cheeks often manifested mitral blush that appears due to the violation of enrichment of blood with oxygen. To the left of the sternum due to the large size of the left ventricle of the heart appears a hump.
Women with such a defect, carry the pregnancy heavier than the left atrium and left ventricle do not cope with a large volume of circulating blood. So, it becomes blood stasis in the vessels of the lungs, shortness of breath, cough, disturbed rhythm, which further exacerbates the patient’s condition.
Diagnosis the doctor examines the patient complaints how long ago he noticed shortness of breath, palpitations, cough, finds out how sick the patient and his close relatives. The inspection of the patient study the skin.
The analysis of urine and blood that can identify the inflammatory processes and associated diseases. The same goal, and biochemical, immunological blood tests.
Also patient is prescribed a number of hardware studies, electrocardiography, coronaroangiography.
Treatment of mitral regurgitation begins with treatment of the underlying disease.
In case of failure minor or moderate degree of special treatment is required.
If diagnosed with severe mitral insufficiency surgical treatment in which applied plastic material, and in severe cases, mitral valve replacement. The tricuspidal insufficiency treated surgically, and exclusively using an electric pump instead of a heart for pumping blood.
Plastic surgery is indicated for failure 23, with the proviso that pronounced changes in the cusps of the mitral valve no. There are three types of plastic surgeries
- ring annuloplasty is performed inserting a support ring near the base of the cusps of the mitral valve
- shortening of chordae tendon fibres that attach the papillary muscles to the muscles of the heart
- partial removal of the rear fold of the valve.
If the detected abrupt changes in the flaps of the mitral valve, subvalvular structures, or in the case of plastics is ineffective, resort to prosthetics. For this purpose, two types of prosthetic mechanical and biological.
Bioprostheses are made from the aorta taken from animals. This method of prosthesis is most often used for treating insufficiency of the mitral valve in women before pregnancy or in children. In all other cases, use of mechanical valves, which are made of special metal alloys.
After implantation of a mechanical prosthesis, patients are assigned a permanent drug therapy with indirect anticoagulants, which inhibit blood coagulation by blocking synthesis in the liver of such substances. If the implanted biological prosthesis, therapy is temporary from 1 to 3 months. If you have plastic valve, necessary in the use of such drugs no.
After surgery may develop a number of complications.
Possible thromboembolism when a blood clot closes the vessel lumen. A blood clot is formed in the area of operations at the seams, on the wings of the valve. The greatest danger of ischemic stroke, and mesenteric thrombosis.
In some cases, developing infective endocarditis, atrioventricular block, paravalvular fistula is thrombosis of the graft. Sometimes the destruction of the biological prosthesis. Then is performed a second surgery. Another common complication of calcification of the biological conduit, whereby the valve is sealed and its mobility is reduced.
There are several conditions for which surgery will not work or are contraindicated. These include irreversible comorbidities, which in the near future people will die, and severe heart failure that is not amenable to medical treatment.
In pregnant mitral insufficiency of 2nd degree, and 1 degree, almost does not show complaints of, usually absent, complications do not happen and it is not life-threatening.
If a pregnant woman has identified 3 or 4 the extent of the disease in the early stages, shown induced abortion and subsequent contraception. Repeated pregnancy is only possible after successful surgical treatment.
Drug treatment involves diuretics for withdrawal of excess fluid from the body, inhibitors for prevention of heart failure, nitrates (salts), potassium products to improve the condition of the heart muscle, in atrial fibrillation cardiac glycosides increase the force of cardiac contractions.
This heart defect can cause many disorders in the body.
Break a heart rhythm that leads to the development of atrial fibrillation due to impaired movement of electrical impulses in the heart.
Perhaps the development atrioventrikuljarnuu embargo which hinder the promotion of electric impulse from the Atria to the ventricles. Develop secondary infectious endocarditis, in which inflamed internal membrane of the heart occurs and damage to his valves.
Occurs cardiac failure, where reduced strength of heart contractions, which leads to insufficient blood supply of organs, there is increased pressure in the blood vessels of the lungs.
The prognosis of this diagnosis depends on the severity of the underlying disease that caused the heart defect, the severity of failure condition of the heart muscle (myocardium).
In moderate deficiency, the patient for several years, is able to maintain good health and ability to work.
Mitral insufficiency 3 degrees and 4 degrees leads to a rapid development of heart failure. More 5 are 90% for more than 10 years 80% of patients.
In pregnant women the consequence of failure can be
the risk of miscarriage, impaired fetal development. The outcome depends on the cause of the disease, the presence of other heart defects, the degree of violation of the blood flow inside the heart.
Primary prevention aimed at the prevention of a wrinkle, consists in the treatment of chronic infection foci (
etc.) and preventing the diseases that lead to valve defects rheumatism, infectious myocarditis, etc. If you already have, you must as soon as possible to begin their treatment. Universal tool hardening from childhood.