Heart disease is a persistent pathological change in its anatomical structures, which leads to disruption of the normal functioning of the cardiovascular system.
The most common heart defects that are associated with damage to its valve apparatus. One of such pathologies is mitral cardiac defect.
General and statistical information
- 1 General information and statistical information
- 2 Clinical manifestations and differences
- 3 Diagnostic methods
- 4 Treatment tactics
General and statistical information
This cardiac defect directly is associated with dysfunction of the bivalve mitral valve , which lies on the left atrial and left ventricular boundary.
The main function of this valve is to provide blood flow only in the direction from the atrium to the ventricle and nothing else. This task is realized due to the special structure of the valve flaps - under blood pressure they open only in one direction
If this mechanism is broken( for example, because the valve flaps are loosely snapped together), the blood from the ventricle will partially return to the left atrium of - a functional impairment of the heart activity and a pathology called "mitral insufficiency".
There is another possible pathology in the mitral valve activity - stenosis, in which the valve aperture narrows and ceases to transmit the required volume of blood at the same time. In this case, not all blood from the atrium enters the ventricle and timely discharge of the atria is hampered, which again leads to a functional cardiac pathology.
The incidence of mitral malformation is from 50 to 70% of cases of all organic heart lesions of .In this case, 2-3 times more often it is diagnosed in women. The leading causes of blemish are rheumatism of the heart( in 90% of patients) or severe infectious diseases( angina, sepsis, syphilis).Modern medicine does not deny the fact of hereditary predisposition to this disease.
Clinical manifestations and differences
The characteristic clinical signs of the disease are such "heart" symptoms:
- dyspnea , which initially is directly related to physical activity, and then proceeds in the form of attacks of cardiac asthma and disturbs the patient even at rest;
- heartbeat is an early symptom that appears in almost all patients suddenly, more often in the evening or at night, interfering with full rest;
- pain in the heart are noted in less than half of all patients, most often unpleasant sensations are localized from the side between the shoulder blades;
- asthenia - patients feel constant fatigue, muscle weakness and are physically inactive;
- pallor in combination with cyanosis nasolabial triangle and fingers and a bright feverish blush on the cheeks;
- cough , initially dry, and then with phlegm and even blood veins;
- feeling of bursting and heaviness in the right hypochondrium - as a symptom of debuting problems with the liver;
- heart hump - characteristic breast protrusion in the heart;
- edema of appears at later stages of the pathological process and is associated with congestive events in the circulatory system;
- marked swelling of the veins on the neck indicates a neglected form of the disease and developing right ventricular failure.
The characteristic external features of decompensated mitral malformation, unlike other acquired cardiac valve pathologies, is the triad of signs:
- pallor of the skin;
- blush in the form of a kind of "butterfly" on the face;
- symptoms of pulmonary hypertension.
|Diagnostic Method||Characteristic Signs of Stenosis||Characteristic Signs of Insufficiency|
|Analysis of anamnesis||Often - anterior rheumatism. Complaints about asthenia.||Often - anterior rheumatism. Complaints about asthenia can be absent for a long time.|
|External examination||Pale in combination with acrocyanosis and blush. Heart hump.|
|Heart auscultation||Murmuring sounds in the heart region or diastolic murmur||Systolic murmur. Weakening of the first tone of the heart.|
|Electrocardiogram||Incompatible in early stages, sometimes with signs of atrial fibrillation||Low informative in early stages|
|Radiography||Heart shape change, pulmonary dilatation||Left atrial enlargement, esophageal displacement|
|Ultrasound of heart with doppler||Pathological change of hemodynamics and enlargement of individual heart chambers||Abnormal blood flow, change in the anatomy of the valve apparatus|
|Cardiac catheterization||Very accurate diagnostic methodki with respect to structural abnormalities of the valve apparatus. In connection with invasiveness, it is practiced only to clarify the diagnosis before surgery.|
Tactics of treatment
Drug therapy of this cardiac defect has the following objectives:
- prophylactic - to prevent the development of complications and relapses of the disease;
- palliative - improve the quality of life of the patient, if immediate radical intervention is impossible.
Conservative medicine offers the following groups of medications to patients with the pathology of this valve:
- antibiotics and antirheumatic drugs - to prevent the recurrence of provocative diseases and infectious complications;
- anticoagulants - for prevention of blood clots;
- cardiac glycosides and adrenoblockers - to reduce manifestations of heart failure and arrhythmia;
- diuretic - to reduce the burden on the cardiovascular system and symptomatic treatment of heart failure.
Various types of heart surgery are practiced to eliminate mitral valve dysfunction:
- Reconstructive plastic operations on the valve, during which anatomical defects that prevent its normal functioning are eliminated. Conducted as a minimally invasive way( balloon valvuloplasty in case of stenosis), and on the open heart.
Patients who underwent this type of surgical intervention do not need lifelong anticoagulant therapy. Unfortunately, if the disease is the result of rheumatic lesions - this kind of operation is almost impossible.
- The valve prosthesis is performed in the overwhelming majority of cases of mitral insufficiency. Both biological and mechanical prostheses are used. Patients after prosthetics are at risk of increased thrombosis and require lifelong anticoagulant therapy.
Heart disease - sounds menacing. The defect of the mitral valve - it seems that this is not a diagnosis at all, but a death sentence. In practice, everything is not so bad. Modern cardiac therapists are sure: detected and not neglected virus can be easily cured by , even with the help of such surgical methods that are not harmless in appearance. But the main thing after all not a way of treatment, and its or his result!