9 Forecasts and prevention measures
Disease of tricuspidvalve is a rheumatic heart disease that is expressed in its inability to prevent reverse flow of blood from the ventricle into the atrium of the
.For this reason, the pressure in the right atrium and veins increases, and the flow of blood from the organs to the heart is significantly hampered. This defect is diagnosed in 33% of patients with rheumatic malformation, usually it is combined with mitral insufficiency or other defects.
Causes and risk factors
Congenital tricuspid valve is very rare - often this vice is acquired , and it can provoke adverse external factors or disease.
organic form of this disease, which is linked to changes in the valve leaflets, can occur for the following reasons :
- closed injury chest, a broken heart accompanied by leaflets;
- is a carcinoid tumor that is most often localized in the intestinal tract. It is capable of producing toxins that are transported to the heart with blood flow, damaging its inner shell;
- rheumatism refers to the most common causes of defect development, and in this case it is accompanied by lesions of other valves;
- infective endocarditis is a serious inflammatory disease of the intracardiac membrane;
- is a surgical intervention that is performed for the treatment of mitral stenosis( fusion of valve flaps) - during the operation of dividing the valves of one valve, it is possible to develop the deficiency of another.
Functional insufficiency or defect, in which the valve flaps are not subjected to change, occurs in the following cases:
- in acute myocardial infarction , when the disease process affects the intrinsic muscles of the ventricles;
- the expansion ring within heart wall , to which are attached the valve flaps, it occurs due to myocarditis, discontinuities chords severe pulmonary hypertension and other diseases or malformations.
Classification and extent( 1, 2, 3 and 4)
By the time of occurrence of tricuspid valve divided into innate and acquired :
- congenital defect is caused by effects on the expectant mother unfavorable factors and can have three variants: abnormality Ebstein,congenital cleft and myxomatous degeneration;
- acquired deficiency arises from internal pathological processes that affect the inner shell of the heart.
Depending on the causes of development, the defect may be organic, that is, associated with changes in the shape or size of the valves, or functional, in which the valves are not subjected to changes, but are unable to perform their work to the fullest.
Based on the evaluation of the expression of reverse blood flow to the right atrium, distinguishes four stages in the clinical course of the disease:
- I degree, at which the reverse movement is practically not determined;
- II degree, when the reverse movement of blood is detected at a distance of two centimeters from the valve;
- III degree, characterized by a reverse blood flow, which is determined at a distance of more than two centimeters;
- IV degree - the reverse flow of blood is detected in a large area of the right atrium.
Dangers and complications of
In patients with a similar diagnosis, has the risk of developing the following complications of :
- cardiac arrhythmias, occurrence of atrial fibrillation, ventricular tachycardia;
- thromboembolism of pulmonary vessels;
- infectious endocarditis of secondary form, accompanied by inflammation of the heart valves;
- atrial aneurysm;
- pneumonia;
- is a progressive failure of the right atrium and ventricle.
The probability of complications depends on the degree of decompensation of the defect, the cause of its occurrence, the possibility of conducting surgery and accompanying diseases, but according to statistics, complications develop in approximately 90% of patients.
Symptoms of
Tricuspid insufficiency of is usually accompanied by the following symptoms of :
- dyspnea, which results from poor blood supply of blood vessels;
- unpleasant sensations and discomfort in the heart, including arrhythmia, cardiac fading, his "fluttering", etc.;
- puffiness of the face, yellow-blue color of the skin of the face and limbs;
- pain and heaviness under the ribs( on the right side) as a result of fluid stagnation in the liver;
- manifestations of the disease on the part of the gastrointestinal tract include belching, flatulence, nausea, a feeling of fullness and heaviness in the abdomen that arise from blood overflow of the vessels of the abdominal cavity;
- frequent urge to urinate at night;
- sensation of pulsation of the vessels of the neck, accompanied by their swelling;
- weakness, fatigue and decreased performance.
From this video you can learn more about the disease:
When to call a doctor
Early diagnosis of a defect plays a very important role in the success of treatment, and also affects the quality and life expectancy of the patient. Therefore, if there is shortness of breath, weakness, fatigue and cyanosis of the skin, which is accompanied by unpleasant manifestations of the digestive tract, a person should immediately and consult a cardiologist, therapist and gastroenterologist and undergo a complete examination of the body.
Diagnosis
The following tests and examinations are performed for the diagnosis:
- Collection of anamnesis and complaints .Asking the patient the appropriate questions, the doctor determines how long the anxiety symptoms have appeared, what is the reason for their occurrence, and also what diseases preceded the development of the defect;
- External inspection of .When examining the patient, cyanosis of the skin, swelling, enlargement of the liver, swelling of the cervical veins, pulsation in the upper abdomen, and listening to heart rhythm disturbances and systolic noises are detected;
- Urine and blood tests .It is carried out with the purpose of definition of pathological process and concomitant lesions of organs;
- ECG .The electrocardiogram allows to diagnose disturbances of the heart rhythm, to reveal an increase in the right atrium and ventricles, as well as blockade of the legs and trunk of the bundle;
- Phonocardiogram of the .The study is conducted to identify systolic murmurs in the projection of the tricuspid valve;
- EchoCG .The main method for detecting heart valve defects, during which their valves are studied for shape changes, the area of the right atrioventricular orifice, the dimensions of the heart cavities, wall thicknesses and other factors that are important in the diagnosis are evaluated;
- Radiography of the chest .It is carried out to assess the size and location of the heart, change its configuration, detect the presence or absence of blood stasis in the vessels;
- Cardiac catheterization of the heart .The essence of the method consists in introducing into the cavity of the organ catheters to measure the pressure in its departments;
- ultrasound of the heart .Ultrasound examination can reveal hypertrophy of the heart walls, deformation of the valves, expansion of the fibrous ring and other changes characteristic of this defect;
- SCT .Spiral computed tomography allows you to get a fairly clear image of the heart based on a series of X-ray images taken at different depths.
Methods of treatment
First of all, it is necessary to eliminate the cause, which led to the appearance of a defect, then proceed to its treatment or elimination. Conservative therapy in this case is in the prevention of heart failure and pulmonary hypertension : the patient is prescribed diuretics, cardiac glycosides, ACE inhibitors, potassium preparations, nitrates.
Surgical treatment of the defect is carried out at II, III and IV degree of its development and corresponding indications.
The types of operations that are recommended in this case include:
- plastic surgery( suture, semicircular or annular annuloplasty) are shown at the II and III degree of development of the insufficiency of the tricuspid valve and the absence of changes in its valves;
- prosthetics is performed with pronounced changes in the valves or structures, as well as in cases when the plastic surgery did not produce the required result - the patient is placed with biological prostheses or mechanical valves that are made of special medical alloys.
After implantation, patients require anticoagulation therapy, which can be short-term( with the implantation of biological prostheses) or permanent - it is performed after the installation of prostheses from medical alloys.
Forecasts and prevention measures
The prognosis for patients primarily depends on the degree of defect development and concomitant diseases. According to statistics, the 5-year survival of patients after surgery is about 60-70%.
In decompensated forms of the disease, accompanied by chronic lung diseases, the prognosis is usually not very pleasant.
The basis for the prevention of this defect is timely treatment of diseases , which can cause a negative impact on the heart.
Despite the fact that the insufficiency of the tricuspid valve is difficult for the treatment of heart disease, with timely diagnosis, modern medicine can significantly increase the duration and quality of life of patients.
