Mitral insufficiency of the heart: causes, symptoms and treatment
Mitral valve inhibits the regurgitation of the blood, that is, prevents the reverse current. For this you need to shut the hole between the left ventricle and atrium, what happens at the closing of the valve leaflets. Mitral valve insufficiency occurs when folds don't fully close, then there is a gap in the hole, and it becomes possible to reverse the movement of blood.
Almost half of people with heart disease, there is such a violation. While mitral regurgitation is usually accompanied by other problems, it can be various stenosis, disease of large vascular.
Why develop a pathology
Mitral valve insufficiency is the result of damage to the valve or structures of the heart. The reasons for this may be quite a lot. Moreover, mitral regurgitation may be acute or chronic and are caused by different problems and diseases.
As a result of damage to various structures of the heart valve worse cope with its function. May suffer as the sash themselves, and the muscles that makes them, or tendon flaps control valve.
Causes of acute insufficiency
- Alteration and destruction in the tissues of the mitral annulus
- Perforation of the valves,
- Tears chords,
- The weakening and destruction of the papillary muscles.
As a rule, the cause of all these injuries become disease. The main and most common reason to date is infective endocarditis. The inflammatory process in this disease can negatively affect the condition of the tissue of the mitral annulus, valve leaflets or to lead to the destruction of the tendon chords.
Some systemic diseases, in particular lupus erythematosus can cause the same damage to cardiac structures. Degenerative processes affecting the cardiovascular system, adversely affect the condition of all tissues of the heart.
As a result of all of these diseases arise of injury, which prevent the valve normally to close the sash, because of their perforation, tear or due to the fact that the damaged muscle and the chord can no longer effectively manage the work of the mitral valve.
The same damage can occur due to trauma, which may occur during heart surgery.
Other causes of acute failure.
- Neoplastic processes in the atrium;
- Rheumatic processes;
- Left ventricular failure.
The causes of chronic failure
- Tissue changes as a result of inflammatoryprocesses;
- Degenerative processes;
- Structural changes;
- Hereditary factors.
Inflammation does not always cause acute changes, it is possible that it flows sluggish, and tissue damage, grow slowly, often unnoticed by the patient. Chronic mitral regurgitation can cause the same diseases as acute. It's a rheumatic fever, infective endocarditis, lupus erythematosus.
Among the degenerative processes that lead to this pathology most often noted myxomatous degeneration, connective tissue disease, calcium deposits in the area of the mitral valve.
Some heart diseases cause structural changes that prevent normal operation of the valve apparatus. For example, in the infarction, cardiomyopathy, endocarditis damaged chord or papillary muscle, which becomes the direct cause of the development of chronic mitral regurgitation. The same consequences can result in prolapse of the valve.
Hereditary diseases are formed in the process of fetal development because of the negative effects on the mother's body. They can also be caused by genetic disorders. Most often mitral regurgitation defects is formed in the valve leaflets and abnormalities in the large vascular.
Features of mitral regurgitation
Hemodynamics in mitral regurgitation, i.e. blood flow, depends on the severity of the pathology.
The degree of failure
With a slight degree of regurgitation is observed directly from the flaps of the mitral valve. It is found in healthy people. Reasonable means the degree of regurgitation, occurring in one-half centimeters from the valve. When third-degree reverse the movement of blood reaches to the middle of the atrium. This leads to some extension of the atrium. Severe deficiency leads to the fact that regurgitation is all the left atrium.
What is the problem
A characteristic noise, which noted by the doctor when listening to the heart, is the main symptom. It is caused by return of blood from the left ventricle into the left atrium.
The diagnosis of mitral valve insufficiency begins with this symptom. Although in mild deficiency may not have any symptoms.
A more serious development of the defect the left ventricle is forced to pump more blood to make more and the one that returns back to the atrium. Ina result, it gradually increased, hipertrofiada. At the same time, increase reduction that is felt by the person as palpitations. Especially noticeable these symptoms when the patient lies on his left side.
As a result of regurgitation blood flows back into the atrium, it should accommodate a larger volume of blood, and it is also gradually increasing. When a significant degree of increase in atrium is not doing its function because there is fibrillation and frequent spasmodic contraction. The pumping function of the heart due this fall.
Further development of the degree of pathology leads to the fact that the Atria do not normally reduced, but only tremble. These problems may be fraught with more serious violations, for example, formation of blood clots, because there is no normal blood flow. Blood clots that form in the heart are very dangerous because they can block the major blood vascular, and this leads to damage of various organs, stroke.
When grade 3 and 4 mitral regurgitation is very severe, which gives an extra load on the heart. People at risk to heart failure, which has symptoms such as shortness of breath, swelling, cough. Damaged heart tissue become more vulnerable, less resistant to infections, so the risk of infective endocarditis increases.
A person with moderate and severe degree of mitral regurgitation there is no proper blood supply to organs, as such a violation leads to a decrease in the pumping function of the heart. Because the organs do not get proper nutrition, the whole body suffers, and this may affect its General condition and health of the patient.
The symptoms of mitral insufficiency
- Shortness of breath,
- Mitral blush.
Symptoms can appear in various combinations. At small of the severity of the problem obvious manifestations may not be. People may feel that it has become faster to be tired, less time to make the day worse tolerate exercise.
All this is usually not perceived symptoms of heart problems, so the pathological process continues to progress.
Methods of diagnosis:
- The urine and blood tests (General, biochemical, immunological);
- Ultrasound of the heart.
Can use other methods for diagnosis, but these are the main, and most often they are enough.
Inspection and conversation with the patient can be identified symptoms andassume the presence of pathology. You need to find out how sick the person is, what his heredity. The tests determine the presence of inflammation, cholesterol, sugar, protein in the blood and other important metrics. The detection of antibodies is possible to assume the presence of inflammation or infection in the heart muscle.
Diagnosis: mitral insufficiency, be sure to do a ECG which shows rhythm of the heart, helps to detect the presence of arrhythmia and other failures, to judge whether there is overloading of the heart and increased his departments. The main method is an ultrasound or echocardiography.
Why do ultrasound of the heart
- To assess the condition of the valve leaflets;
- To see how close the sash;
- To understand the size of the ventricles and Atria;
- To measure the thickness of the cardiac walls;
- To detect the thickening of the inner lining of the heart.
Dopplebock is a study that shows how blood flows. This diagnostic method enables to detect the reverse current of blood, which is typical for that disorder as mitral valve insufficiency.
How to treat mitral regurgitation
If you identified the symptoms and diagnosed with mitral regurgitation, it is necessary to determine the cause of defect of a heart valve. First and foremost you need to treat the disease, which has led to this condition. If the problem is expressed slightly or moderately, as a rule, additional treatment of mitral valve is not required.
If the degree of damage is more serious or there were complications (heart failure, arrhythmia), need medication.
In severe mitral regurgitation, the treatment should be complex, you may need surgery.
Mitral insufficiency surgically treated with operations with artificial blood circulation.
In plastic surgery, which are performed in 2-3 stages of the disease, may be the installation of a special support ring in close proximity to the valves, shorten the chord of the flap. After surgery, normal blood flow, and its own valve is preserved.
If plastic surgery didn't produce results or tissue is severely damaged, then you need dentures. Use biological or mechanical prostheses. For the manufacture of biological animal tissues are used, mechanical are made of special alloys.
Features of the postoperative period
- After plastic surgery is not required anticoagulant therapy.
- After implantation of a biologicalprosthesis the use of anticoagulants is necessary in 2-3 months.
- After the installation of an artificial prosthesis anticoagulants are prescribed for continuous use.
The success of treatment of insufficiency of the mitral valve and how people will feel after the operation depends on the degree of the manifestations of insufficiency and regurgitation, from the dynamics of the disease and individual characteristics. It is important not to delay diagnosis and treatment.