Mitral valve insufficiency
The mitral valve - a valve located between the left atrium and the left ventricle, which prevents the regurgitation of blood into the left atrium during systole.
Mitral insufficiency or mitral insufficiency - the inability to prevent the valve regurgitation of blood from the left ventricle into the left atrium.
Regurgitation - fast blood flow in the opposite direction of normal movement that occurs during systole.
Mitral insufficiency is rare isolated (about 2% of the total number of heart disease). It is accompanied by malformations of the aortic valve stenosis, mitral orifice.
There are functional (relative) and the organic mitral regurgitation.
Functional mitral regurgitation due to the acceleration of blood flow in dystonia, a change in the tone of the papillary muscle fibers, dilation (widening) of the left ventricle, which provides hemodynamic overload of the heart.
Organic mitral insufficiency develops due to anatomic lesions of connective tissue of the valve plate and tendon strands, locking the valve.
Hemodynamic violation of these types of mitral insufficiency have the same character.
Hemodynamic disturbances in various forms of mitral insufficiency
Systole - a series of successive reductions in ventricular and atrial specific phase of the cardiac cycle.
The pressure of the aorta is significantly greater than the pressure of the left atrium, thereby regurgitation. During systole, there is a reverse flow of blood in the left atrium due to incomplete cover of atrioventricular valve opening doors. As a result, an additional portion of diastole blood flows. During ventricular diastole, a significant amount of blood coming from the atrium into the left ventricle. Consequently, there is an overload disorders left heart, thus increasing force of contraction of the heart muscle. There has hyperactivity infarction. In the initial stages of mitral insufficiency there is a good compensation.
Mitral insufficiency leading to hypertrophy of the left ventricle and left atrium, resulting in increased pressure in the pulmonary vessels. Spasm of arterioles causes lung pulmonary hypertension, resulting in growing hypertrophy of the right ventricle, tricuspid valve.
Mitral valve insufficiency: symptoms, diagnosis
With good compensation mitral valve no symptoms. Severe mitral insufficiency is characterized by the following symptoms:
- Shortness of breath and heart rhythm abnormalities during physical activity (then at rest);
- Cardiac asthma (shortness of breath sudden attacks);
- Pain and swelling in the right upper quadrant, due to increase in liver;
- Swelling of the lower extremities;
- Dry cough with little sputum, in rare cases, mixed with blood;
- Pain in the heart stabbing, crushing, aching, not associated with physical activity.
When compensated mitral regurgitation symptoms may not appear for several years. Severity of symptoms caused by the force of regurgitation.
For the diagnosis of mitral insufficiency using the following methods:
- ECG reveals signs of overload and hypertrophy of the left ventricle and atrium, in the third stage - right heart;
- Echocardiography - Definition of hypertrophy and dilatation of the left heart;
- X-ray examination of the chest - to determine the degree of pulmonary venous hypertension, the degree of protrusion of the arcs of the atria;
- Ventriculography - determining the presence and degree of regurgitation;
- Ventricular catheterization - Determination of the dynamics of pressure in the ventricles of the heart.
Currently, there is overdiagnosis of mitral insufficiency. Modern methods of investigation have shown that the minimum degree of regurgitation may be present in a healthy body.
Mitral regurgitation 1 degree: the clinical picture
Mitral insufficiency is characterized by 1 degree compensated hemodynamics and valve failure to prevent backflow of blood, which is achieved by hyperactivity of the left ventricle and atrium. This stage of the disease is characterized by the absence of symptoms of circulatory failure, well-being of the patient during exercise. In the diagnosis of mitral regurgitation 1 degree detected a slight expansion of the boundaries of the heart to the left, the presence of systolic noise. Electrocardiographic signs of valve dysfunction are absent.
Mitral valve insufficiency of 2 degrees: the clinical picture
Mitral regurgitation grade 2 characterized by the development of passive forms of venous pulmonary hypertension. This stage is characterized by a number of symptoms of circulatory disorders: shortness of breath and heart palpitations during exercise and at rest, cough, attacks of cardiac asthma, hemoptysis. In the diagnosis of mitral regurgitation grade 2 found expansion of the boundaries of the heart to the left (1 - 2 cm) to the right (to 0, 5 cm) and up, systolic murmurs. Electrocardiogram shows changes atrial component.
Mitral regurgitation grade 3: the clinical picture
When mitral regurgitation grade 3 develop right ventricular hypertrophy, which is accompanied by characteristic symptoms: enlargement of the liver, development of edema, increased venous pressure.
Diagnosis of mitral regurgitation grade 3 reveals a significant expansion of the boundaries of the heart muscle, intense systolic murmurs. An electrocardiogram shows the presence of mitral wave, signs of left ventricular hypertrophy.
Treatment of mitral valve forecasts
Treatment of mitral valve regulated only rule: the patient is diagnosed with mitral insufficiency - a surgical patient. This pathology is not subject to medical correction. The task of the cardiologist is the correct preparation of the patient for surgery.
Conservative treatment of mitral valve insufficiency is aimed at controlling the heart rate, as well as on the prevention of thromboembolic complications, reduction in the degree of regurgitation. Also suitable symptomatic treatment.
During surgery performed mitral valve implantation.
The prognosis of mitral regurgitation are entirely dependent on the degree of regurgitation, valvular defect severity and dynamics of the disease.