Mitral valve failure What is this and what is the forecast of life with NMK? The severity of the disease. Symptoms of mitral insufficiency

Date: 27.03.2019

The mitral valve blocks blood regurgitation, that is, prevents its reverse current. To do this, it is necessary to overlap the hole between the left ventricle and the atrium, which happens when the valve flap is closed. Failure mitral valve It manifests itself when the sash can not fully come true, then there remains a lumen in the hole, and the opposite movement of blood becomes possible.

Almost half of people having a heart disease is a similar violation. At the same time, mitral insufficiency is usually accompanied by other problems, these can be various stenosis, pathology of large vessels.

Why pathology develops

The insufficiency of the mitral valve becomes the result of damage to the valve itself or heart structures. There may be a lot of reasons for this. And it can be acute and chronic and caused different problems and diseases.

As a result of damage to various heart structures, the valve copes worse with its function. You can suffer both sash themselves and muscles that ensure their work, or tendons control valve flaps.

Causes of acute insufficiency

Changes and destruction in the tissues of the Mitral Ring
Perforation of sash,
Rales are chord
Weakening and destruction of papillary muscles.

As a rule, diseases are caused by the cause of all of these damage. The main and most frequent cause Today is infectious endocarditis. The inflammatory process in this disease can negatively affect the state of tissue of the mitral ring, valve flaps or lead to the destruction of tendon chord.

Some systemic diseases, in particular, the red lupus can lead to the same damage to heart structures. Degenerative processes spreading to cardiovascular system, negatively affect the condition of all tissues of the heart.

As a result of all these diseases, there are damages that interfere with the valve normally bow the sash due to their perforation, breaking or due to the fact that damaged muscles and chords can no effectively manage the work of the mitral valve.

The same damage may occur due to injury that may occur during the operation on the heart.

Other reasons acute insufficiency.

Tumor processes in atrium;
Rheumatic processes;
Left-deuded failure.

Causes of chronic insufficiency

Changes in tissues due to inflammatory processes;
Degenerative processes;
Infections;
Structural changes;
Hereditary factors.

The inflammatory process does not always cause sharp changes, it is possible that it flows sluggish, and tissue damage is growing slowly, often unnoticed for the patient. The chronic form of the disease can cause the same diseases as acute. This is infectious endocarditis, red lupus.

Among the degenerative processes, which lead to this pathology, most often note the mixing degeneration, diseases of the connective tissue, calcium deposits in the field of mitral valve.

Some heart diseases lead to structural changes that impede normal work valve apparatus. For example, as a result of a heart attack, endocarditis is damaged by chords or papillary muscles, which becomes direct reason Development of chronic insufficiency. The same consequences can lead.

Hereditary pathologies are formed in the process intrauterine development due to negative influences on the mother's body. They can also be due to genetic disorders. Most often, it is formed during defects of valve flaps and pathology of large vessels.

Features

Hemodynamics in mitral insufficiency, that is, blood flow depends on the degree of expression of pathology.

Degree of insufficiency

Insignificant;
Moderate;
Pronounced;
Heavy.

With a slight degree, regurgitation is observed directly at the mitral valve flaps. She meets healthy people. A moderate degree means regurgitation occurring in one and a half centimeters from the valve.

For a third degree, the inverse movement of blood comes to the middle of the atrium. This leads to some expansion of the atrium. Severe degree of failure leads to the fact that regurgitation takes everything left atrium.

How the problem is manifested

A characteristic noise that the doctor notes while listening to the heart is the main symptom. It is caused by the return of blood from the left ventricle in the left atrium.

The diagnosis is starting with this symptom. Although light insufficiency may not be any symptoms.

With a more serious development of the damage, the left ventricle is forced to download more blood to accept the one that returns back in atrium. As a result, it gradually increases, hypertrophy. At the same time, its abbreviations increase, which is felt by a person as a reinforced heartbeat. These symptoms are especially noticeable when the patient lies on the left side.

Since, as a result of regurgitation, blood returns in the atrium, it should accommodate a greater amount of blood, and it also gradually increases. With a large degree of atrial increment, it does not cope with its function, because fibrillation and frequent neurotic cuts occur. The pumping function of the heart is falling as a result of this.

Further development of the degree of pathology leads to the fact that atrium is generally not reduced normally, but only trembling. These problems can be fraught with more serious disorders, for example, the formation of blood clots, because there is no normal blood flow. The blood clots formed in the heart are very dangerous, because they can overlap large vesselsAnd this leads to damage to various organs, stroke.

At 3 and 4, regurgitation is very pronounced, which gives an additional load on the heart. A person risks getting heart failure, which has such symptoms like shortness of breath, swelling, cough. Damaged heart tissue becomes more vulnerable, resist infections less, therefore the risk of infectious endocarditis increases.

A person with a moderate and pronounced degree has no full blood supply to organs, since such a violation leads to a decrease in the pump function of the heart. Since the organs do not receive normal nutrition, the whole body suffers, and it can affect its general condition And the health of the patient.

Symptoms

Reinforced heartbeat
Increased fatigue,
Swelling,
Dyspnea,
Cough,
Cyanosis,
Mitral blush.

Symptoms can manifest in various combinations. With a small degree of severity, the problem of obvious manifestations may not be. A person may feel that he has become faster to get tired, it goes less to do for a day, worse tolerates physical exertion.

All this is usually not perceived for the symptoms of the heart problem, so the pathological process continues to progress.

Diagnostics

Diagnostic methods:

Inspection;
Urine and blood analysis (general, biochemical, immunological);
Dopplerhokg;
Ultrasound of the heart.

Other methods for diagnosis can be used, however, these are the main, and most often they are enough.

Inspection and conversation with patients allow you to highlight the symptoms and assume the presence of pathology. It is necessary to find out what a person hurt, what is his heredity. Analyzes allow you to determine availability inflammatory process, cholesterol, sugar level, blood protein and other important indicators. When an antibody detects, the presence of inflammation or infection in the heart muscle can be assumed.

For diagnosis: Must make an ECG, which shows the rhythm of the heart of the heart, helps to detect the presence of arrhythmia and other failures, to evaluate whether there is an overload of the heart and whether its departments are increased. The main method is ultrasound or echocardiography.

Why do ultrasound of heart

Estimate the state of the valve sash;
See how the sash are closed;
Understand the size of the ventricles and atria;
Measure the thickness of the heart walls;
Detect the thickening of the inner shell of the heart.

Dopplerhokg is a study that shows how blood moves. This diagnostic method makes it possible to reveal the reverse blood flow that is characteristic of this vice.

How to treat the disease

If symptoms are revealed and diagnosed, then you need to find out the reason for the vice heart valve. First of all, it is necessary to treat the disease that led to such a state. If the problem is expressed slightly or moderately, then, as a rule, additional treatment not required.

If the degree of lesion is more serious or arose complications (heart failure, arrhythmia), then you will need medicia treatment.

With pronounced insufficiency, treatment must be complex, it may take a surgical operation.

Surgically is treated with the help of operations conducted with artificial blood circulation.

With plastic operations that are performed at 2-3 degrees of the disease, a special support ring near the flaps can be installed, chords, sash are shortened. After the operation, blood flow is normalized, and its own valve is saved.

If the plastic surgery did not bring the result or tissue is badly damaged, then prosthetics are necessary. Biological or mechanical prostheses are used. For the manufacture of biological, animal tissues are used, mechanical are performed from special alloys.

Features of the postoperative period

After plastic surgery, anticoagulant therapy is not required.
After impact of the biological prosthesis, the reception of anticoagulants is necessary within 2-3 months.
After installing an artificial prosthesis, anticoagulants are assigned to permanent reception.

The success of treatment and how a person will feel after the operation depends on the degree of manifestations of insufficiency and regurgitation, from the dynamics of the disease and individual features. It is important not to postpone the diagnosis and treatment.

Mitral insufficiency is a variety of valve heart defects. Pathogenesis is due to incomplete closure mitral holeWhat precedes the disorders of the structure of the flaps, tissues under the valves.

Pathology is characterized by the regurgitation of blood into the left atrium from the left ventricle. Consider in detail what it is, the nature of the development and the clinical picture of the flow of deficiency of the mitral valve at 1, 2 and 3 degrees of the disease, methods of its treatment and the forecast of return to normal life.

N IMK (Mitral Valve Insufficiency) is the most popular cardiac anomaly. Of all sick crops 70% suffer from an isolated form of NMC. Usually rheumatic endocarditis is the main root cause of the disease. Often a year after the first attack, the condition of the heart, which is quite difficult to cure.

The greatest risk group includes people sick with Walvulitis. This disease damages the valve sash, as a result of which they are exposed to wrinkling processes, destruction, gradually become shorter compared to the initial length. If Walvulitis is in late step, calcification is developing.

Additionally, due to the listed diseases, the length of the chord is reduced, dystrophic and sclerotic processes occur in papillary muscles.

Septic endocarditis leads to the destruction of many heart structures, so the NMC has the strongest manifestations. The valve flaps are adjacent to each other are not enough tight. With their incomplete closure through the valve occurs too strong blood outletthat provokes it to reboot and the formation of congestive processes, an increase in pressure. All signs lead to the increasing deficiency of MK.

Causes and risk factors

NMC suffer from people with one or more of the following pathologies:

Congenital predisposition.
Syndrome connecting displasia.
Mitral valve prolapse, characterized by regurgitation 2 and 3 degrees.
Destruction and choser chord, rupture of MK leafs due to injury in the chest injury.
Tarve the leaf and chord during development.
Destruction of the apparatus combining valves, with endocarditis, which occurred due to diseases of the connective tissue.
Infarction parts of the mitral valve followed by the formation of the scar in the sublink area.
Changing the shape of the flaps and tissues under the valves, rheumatism.
Increased mitral ring with dilatation cardiomyopathy.
Insufficiency of the function of the valve in the development of hypertrophic cardiomyopathy.
MC insufficiency due to the operation.

Types, shapes, stages

With NMK. the overall shock volume of the left ventricular blood is estimated.. Depending on its number, the disease is divided into 4 degrees of gravity (as a percentage is part of the blood, which is redistributed incorrectly):

I (most soft) - up to 20%.
II (moderate) - 20-40%.
III (medium shape) - 40-60%.
IV (the hardest) - over 60%.

According to the forms of flow, the disease can be divided into acute and chronic:

In determining the peculiarities of the movement of mitral flaps allocated 3 types of pathology classification:

1 - the standard level of mobility of the sash (in this case, painful manifestations are consisting in dilatation of the fibrous ring, softening vessels).
2 - destruction of sash (the greatest damage takes chords, as their pulling or gap occurs, also manifests a disruption of the integrity of the nobble muscles.
3 - Reducing the mobility of the sash (forced connection of the commission, reduction of the length of chord, as well as their splicing).

Danger and complications

With the gradual progression of NMC, such violations are manifested:

Thrombembolia on the basis of constant stagnation of a large part of blood.
Valve thrombosis.
Stroke. Great importance In the risk factors, the stroke has occurred earlier than the valve thrombosis.
Cleaning arrhythmia.
Symptoms of chronic heart failure.
Mitral regurgitation (partial refusal to perform functions with a mitral valve).

Mitral valve deficiency is a variety of valve-type heart defects. The pathogenesis is due to the incomplete closure of the mitral opening, which is preceded by violations of the structure of the flaps, tissues under the valves. Pathology is characterized by the regurgitation of blood into the left atrium from the left ventricle.

Symptoms and signs

The severity and severity of the ICT depends on the degree of its development in the body:

1 Stage Diseases have no specific symptoms.
2 Stagedoes not allow patients to exercise physical exemplary mode, as shortness of breath, tachycardia immediately manifests itself painfulness in the chest, knocking the rhythm of the heart, easy sensations. Auscultation in mitral insufficiency determines the increased intensity of the tone, the presence of a noise background.
3 Stage Characterized by deficiency of left ventricle, pathologies of hemodynamics. Patients suffer from a permanent shortness of breath, orthopneus, accelerating the rhythm of the heart, feel discomfort in the chest, their skin Covers Pale than in a healthy state.

Learn more about mitral insufficiency and hemodynamics with it from a video clip:

When to contact the doctor and to what

When identifying the symptoms characteristic of MTC immediately turn to the cardiologist, To stop the disease in the early stages. In this case, you can avoid the need for consultation with other doctors.

Sometimes there are suspicions of rheumatoid etiology of the occurrence of the disease. Then you should visit the rheumatologist to form a diagnosis and prescribing proper treatment. If there is a need for operational intervention, treatment and subsequent elimination of the problem conducts cardiac surgery.

Symptoms Mitral Insufficiency can be similar to the signs of other acquired heart defects. More about how they manifest themselves, we wrote.

Diagnostics

Common methods for identifying NMK:

More about symptoms and diagnostics Find out of the video:

It is necessary to distinguish the NMC from other pathologies of the heart:

Myocarditis in severe form.
Congenital and acquired heart defects of adjacent etiology.
Cardiomyopathy.
Prolapse MK.

And how to cure from this problem? All details can be found in an affordable review.

On the symptoms of the lack of aortic valve and the differences of this heart defect from the material described in this article in another material.

Read also with information about how the Behalet's disease is also dangerous, with methods of treating this.

Methods of therapy

With pronounced symptoms of the NMC, the patient is shown surgical intervention. An introduced operation is performed for the following reasons:

In the second and later stages, despite the fact that the volume of blood release is from 40% of its total.
In the absence of the effect of antibacterial therapy and exacerbation of an infectious endocarditis.
Strengthened deformations, sclerosis of flaps and tissues located in the linked space.
If there are signs of the progressive dysfunction of the left ventricle together with the overall heart failure flowing at 3-4 degrees.
Heart failure in the early stages can also be caused for the operation, however, for the formation of testimony, thromboembolism is to be found in the size of vessels located in a large circulation circle.

Operations are practiced:

Valve-cooling reconstructive operations are necessary for the correction of the NMC in childhood.
Commuroplasty and decalcification of sash are shown in pronounced MK insufficiency.
Chordoplasty is designed to normalize mobility of sash.
Translocation Cord is shown in their disposal.
Fixing parts of the papillary muscle is carried out using teflon gaskets. This is necessary when the muscle head is separated with the rest of the components.
The prosthetics of chord is necessary when they are complete degradation.
Walvoplasty avoids the rigidity of the sash.
Analoplasty is designed to get rid of the patient from regurgitation.
The valve prosthetics is carried out in its strong deformation or the development of irreparable and interfering normal vital activity of fibrosclerosis. Mechanical and biological prostheses are used.

Learn about minimally invasive operations in this disease from the video clip:

What to wait and measures of prevention

With the development of the NMC, the forecast determines the severity of the course of the disease, that is, the level of regurgitation, the emergence of complications and irreversible changes in heart structures. Survival for 10 years after diagnosis is higher than in similar heavy pathologies.

If the lack of valve is manifested in moderate or medium, women have ability to enter and give birth to children. When the disease acquires chronic flowAll patients should take an ultrasound every year and attend cardiologist. With the appearance of deterioration, it is necessary to apply visits to the hospital more often.

With a worsening of the state, surgery is being taken, so patients should always be prepared for a given extent from the disease.

The prevention of the NMC is in the prevention or early treatment of diseases causing this pathology. All diseases or manifestations of mitral valve deficiency due to its improper or reduced valve must be quickly diagnosed and carried out timely treatment.

NMK is dangerous pathologyleading to severe destructive processes in heart tissue, therefore needs proper treatment. Patients subject to the doctor's recommendations may some time after the start of treatment

The mitral valve is a valve located between the left atrium and the left ventricle of the heart, which prevents blood pressure regurgitation into the left atrium during systole.

Mitral valve failure or mitral insufficiency - the inability of the valve prevent the blood regurgitation from the left ventricle into the left atrium.

Regurgitation is a rapid blood flow in the direction, reverse normal movement arising during systole.

Mitral insufficiency is rarely occurring isolated (about 2% of total heart disease). It is accompanied by vices of aortic valves, stenosis of the mitral hole.

There are functional (relative) and organic mitral insufficiency.

Functional Mitral Insufficiency is due to the acceleration of blood flow during dystonia, a change in the tone of papillary muscle fibers, dilatation (expansion) of the left ventricle, which provides hemodynamic overload of the heart.

Organic Mitral Insufficiency Develops due to anatomical lesion of the connective tissue plates of the valve itself, as well as tendon filaments fixing the valve.

Hemodynamic violations of these types of mitral insufficiency are the same.

Violation of hemodynamics with various forms of mitral insufficiency

Systole - a series of consecutive contractions of the myocardial of ventricles and the atria of a certain phase of the heart cycle.

The pressure of the aorta significantly exceeds the pressure of the left atrium, which contributes to regurgitation. During systole, the reverse blood flow occurs in the left atrium, due to the incomplete cover of the atrioventricular opening of the valve with the valve. As a result of this, an additional portion of blood comes into diastole. During the ventricular diastole, the considerable amount of blood comes from the atrium into the left ventricle. As a result, the violations the overload of the left sections of the heart occurs, which contributes to an increase in the strength of the reduction in the heart muscle. Mocardium hyperfunction is observed. On the initial stages The development of mitral insufficiency arises good compensation.

Mitral insufficiency leads to the hyperrophy of the left ventricle and the left atrium, as a result of which the pressure in the pulmonary vessels increases. Spasm of the lung arteriole causes pulmonary hypertension, as a result of which the hypertrophy of the right ventricle develops, the insufficiency of the three-grained valve.

Mitral valve failure: symptoms, diagnostics

With a good mitral valve compensation, the symptoms are not manifested. Pronounced mitral insufficiency is characterized by the following symptomatics:

Shortness of breath and violation of cardiac rhythms physical activity (then at rest);
Cardialgia;
Increased fatigue;
Cardiac asthma (attacks with sharp shortness of breath);
Pain, swelling in the right hypochondrium, due to increased liver;
Swelling of the lower extremities;
Dry cough with a small wet compartment, in rare cases with blood impurities;
Pain in the heart of a cigrier, gone, nocturing character, not associated with physical activity.

With compensated deficiency of the mitral valve, symptoms may not appear for several years. The severity of symptoms is due to the power of regurgitation.

The following methods are used to diagnose mitral insufficiency:

ECG allows you to identify signs of overload and hypertrophy of the left ventricle and atrium, in the third stage - the right heart of the heart;
Echocrine - determination of hypertrophy and dilatation of the left heart departments;
Radiographic study of organs chest - determination of the degree of pulmonary venous hypertension, the degree of appealing of the atrial arc;
Ventriaculture - determination of the presence and degree of regurgitation;
Catethery of ventricles - determination of pressure dynamics in the ventricles of the heart.

Currently, there is a hyperdiagnosis of mitral insufficiency. Modern methods Studies have shown that the minimum degree of regurgitation may be present in a healthy body.

Mitral valve failure 1 degree: clinical picture

The lack of a mitral valve of 1 degree is characterized by compensation of hemodynamics and valve inability to prevent the reverse current of blood, which is achieved by hyperfunction of the left ventricle and atrium. This stage of the disease is characterized by the absence of symptoms of insufficiency of blood circulation, the patient's good self-sensitivity during exercise. When diagnosing the insufficiency of the mitral valve 1 degree, a slight expansion of the heart boundaries left, the presence of systolic noise is detected. On the electrocardiogram, the sign of the violation of the valve function is absent.

Mitral valve failure 2 degrees: clinical picture

The insufficiency of the mitral valve is 2 degrees is characterized by the development of the passive form of venous pulmonary hypertension. This stage is characterized by a number of symptoms of circulatory disorders: shortness of breath and a rapid heartbeat in physical activity and at rest, cough, attacks of cardiac asthma, hemoptysis. When diagnosing the lack of mitral valve 2 degrees, the expansion of the heart boundaries left (1-2 cm), to the right (up to 0.5 cm) and up, systolic noises are detected. The electrocardiogram shows the changes of the atrial component.

Lack of mitral valve 3 degrees: clinical picture

In case of insufficiency of the mitral valve of 3 degrees, hypertrophy of the right ventricle is developing, which is accompanied by characteristic symptoms: an increase in liver, the development of swelling, an increase in venous pressure.

Diagnostics of lack of mitral valve 3 degree detects a significant expansion of the boundaries of the heart muscle, intense systolic noises. The electrocardiogram shows the presence of a mitral tooth, signs of left-selling hypertrophy.

Treatment of mitral valve deficiency, forecasts

Treatment of mitral valve deficiency is regulated by the only rule: a patient with a diagnosed mitral insufficiency is a surgical patient. This pathology is not subject to medical correction. The task of the cardiologist is proper preparation Patient to surgery.

Conservative treatment The lack of mitral valve is aimed at monitoring the frequency of heart abbreviations, as well as the prevention of thromboembolic complications, reducing the degree of regurgitation. Also used symptomatic treatment.

In the course operational intervention Mitral valve implantation is performed.

Forecasts in mitral insufficiency are completely dependent on the degree of regurgitation, the severity of the valve defect and the dynamics of the disease.

Video from YouTube on the subject of Articles:

Norma U. healthy man The mitral valve completely overlaps the hole between the left ventricle and the atrium so that the reverse blood flow occurred. When the valve defect, the hole is completely closed and leaves the lumen. In the systole phase, the blood comes back to the left atrium (regurgitation phenomenon), where its volume and pressure increases. After that, the blood enters the left ventricle, and the volume also grows there.

Description and causes of pathology

This pathology is more affected by adults than children. Often, mitral insufficiency is accompanied by vices. blood vessels and stenoses (compression of the lumen). IN pure form It is extremely rare.

This vice is less likely congenital and more often acquired. Degenerative changes in some cases affect the flaps and valve tissues and the structures under it. In others, chords are amazed, the valve ring is overly stretched over.

Some of the causes of acute deficiency of the mitral valve are strong dull injury Hearts or. With these diseases burst poofer muscles, chord tendons, and the valve flaps also come off.

Other reasons for the development of mitral insufficiency:

inflammation of the joints;
restrictive cardiomyopathy;
some autoimmune diseases.

With all these systemic diseases, observed chronic insufficiency Mitral valve. Genetic diseases S. chromosomal mutationsaccompanied by connective tissue defects systemic character, lead to lack of mitral valve.

Ischemic violation of the valve function is found in 10% of cases. , donkeys or shortening of the mitral valve with the elongation of chord tendons and papillary or papillary muscles also lead to mitral insufficiency.

Relative Mitral Valve Insufficiency may occur without its structural changes as a result of expanding the left ventricle and fibrous ring. This can occur when:

cardial aortes;

Very rarely, the lack of a mitral valve is a consequence of the calcinosis of valve flaps or hypertrophic myopathy.

For congenital mitral insufficiency, the presence of the following diseases is characteristic:

parachute shaft deformation of the valve;
splitting of mitral flaps;
artificial fenestration.

Symptoms of heart valve pathology

The symptoms of this pathological process are growing as insufficiency develops. During the period of compensated deficiency of the mitral valve, the symptoms may not appear. This stage can give a long flow (up to several years) without any symptoms.

Subcompensated degree of insufficiency is accompanied by:

development in patient breath;
fast fatigue appears during physical and mental work;
weakness;
the rapid heartbeat even at rest;
dry cough and hemoptysis.

In the process of developing stagnation in the venous circulation of blood circulation, it develops, manifested in the form of a night cough, the patient "lack air". Patients complain about painful pain in the heart area, irradiating to the left shoulder, forearm, blade and brush (anginal pain).

With the further flow of pathology, the deficiency of the right ventricle of the heart is developing. There are such symptoms as:

akricyanoz - the syncity of the limbs;
swelling legs and hands;
vienna neck swelling;
ascites develops (cluster fluid in the abdominal cavity).

When palpation feels an increase in the liver. The expanded atrial and the pulmonary trunk squeeze the Horthland nerve, impoverish appears - the Ortner syndrome.

In the decompensated stage more Patients are diagnosed.

Types of pathologies of the mitral valve

Depending on the flow of the pathological process, an acute or chronic mitral insufficiency occurs.

For reasons, the occurrence is the ischemic and non-haemic failure of the mitral valve.

If there is a pathology from the structure of the valve, they are talking about organic mitral insufficiency. In this case, the lesions affect either the valve itself, or the threads of the tendons fixing it.

For diseases of the heart muscle, due to hemodynamic overvoltage. As a result, the relative or functional insufficiency of the mitral valve is developing.

The degree of flow of the disease

Depending on the size of the lumen and the degree of expression of regurgitation, the clinical degrees of manifestation of mitral insufficiency are determined:

The lack of a mitral valve of 1 degree - compensated is characterized by a slight blood flow (less than 25%) and violations only by the structure of the valve. Well-being does not change, there are no symptoms and complaints. ECG diagnostics does not identify pathology to this extent. With auscultation, the cardiologist hears minor noise during systole when closing the valve flaps, the heart boundaries are slightly wider than the norm.
For mitral insufficiency of the 2 degree, subcompensated, characterized by the filling of the atrium with blood almost to half (up to 25-50%). For the liberation of the atrium from blood develops. Man at this moment suffers from shortness of breath, even during peace, dry cough. ECG diagnose changes in atrium. During listening, noise is determined during the systole period, the heart boundary increases, especially on the left (up to 2 cm).
The lack of a mitral valve of 3 degree is accompanied by a filling of the left atrium with blood to 90%. Its walls increase in size. A decompensated stage begins, in which blood is not excreted from the atrium. There are symptoms such as edema, an increase in the size of the liver during palpation. There is an increase in venous pressure. ECG signs are diagnosed: an increase in left ventricle, a mitral teeth. With auscultation - reinforced noise in systole, the expansion of heart borders, especially the left.
4 The degree of mitral insufficiency is called dystrophic. Pathological structural changes of the valve, blood stagnation in a small circulation of blood circulation. Symptoms of the third degree significantly increases. Surgical operations Very widely used in this stage and give a favorable permission.
5 degree - terminal. Patients are observed clinical picture third stage of cardiovascular failure. The patient's condition is very severe and does not allow operational interventions. The forecast of the pathology of pathology is extremely unfavorable, most often is a fatal exodus due to complications.

Diagnosis of the pathology of the mitral valve

The diagnosis of mitral insufficiency should be carried out on the basis of the following integrated activities:

conversation, inspection, palpation and percussion, auscultation of the patient;
data;
chest radiography data;
data;
heart ultrasound data;
the results of the probation of heart cavities;
ventriculography data.

Competent collection of anamnesis during a thorough questioning, inspection, palpation and percussion of the patient can coordinate the doctor on further research For accurate diagnosis. At percussion, the extended heart boundaries are determined, especially on the left side. During auscultation, depending on the degree of mitral insufficiency, systolic noises of different intensity are detected.

According to radiographs and ECG, the expansion of the left ventricle and the atrium is diagnosed.

Most informative method Diagnostics - echocardiography, here you can estimate the defect and the degree of damage to the valve itself. For more specific diagnostics in the presence of atrial fibrillations, a government echoch is applied.

Treatment of cardiac pathology

With the insufficiency of the mitral valve, only a cardiologist must be prescribed treatment. You can not engage in self-medication and resort to folk methods!

Treatment should be aimed at eliminating the cause that caused mitral insufficiency, that is, the disease preceding the pathological process.

Depending on the degree of mitral insufficiency and severity, medical treatment can be carried out, in some cases a surgical operation is necessary.

Light and moderate degree requires reception medicinal preparations, the action of which is aimed at reducing the heart rate, vasodilating drugs (vasodilators). It is important to conduct a healthy lifestyle, not to drink and not smoke, avoid states of physiological overwork and psychological stress. Showing walks in the fresh air.

In case of insufficiency of the mitral valve of 2 degrees, as well as for the third, life-long anticoagulants are prescribed to prevent vessel thrombosis.

Surgical solution problem

Starting with the third degree, under explicit pathological changes, they resort to surgical recovery of the valve. Need to do as soon as possible so that irreversible dystrophic changes In the left ventricle.

There are the following testimony for the operation:

reverse blood outflow is more than 40% of blood emissions with heart;
there is no positive effect in the treatment of infectious endocarditis;
irreversible sclerotic changes of the mitral valve;
strong dilatation of right ventricle, systole dysfunction;
vessel thromboembolia (one or set).

Carry out reconstructive operations on valve flaps, its ring. If such an operation is not possible, then the valve is reconstructed - the removal of damaged and replacing it with artificial.

Modern medicine applies the highest-tech xenopericardial and synthetic materials for the prosthetics of the mitral valve. There are also mechanical prostheses that make special metal alloys. Biological prostheses imply the use of animal tissues.

IN postoperative period Risk increases, therefore appoints appropriate drugs. In rare cases, damage to the prosthetized valve occurs, then it is carried out another operation and put the second synthetic valve for replacement.

Prediction and prevention

A favorable forecast for mitral deficiency 1-2 degrees is given in almost 100% of cases. The patient can maintain his performance for many years. It is important to be under the supervision of specialists, to undergo consultation and diagnostic examinations. With such phases of the disease, even pregnancy and tooling the child are allowed. The permission from childbirth in these cases is carried out by conducting cesarean section.

Stronger pathological changes in insufficiency lead to severe violations from the circulatory system as a whole. Adverse predictions are usually assumed when attaching to the vice. Mortality rate for this category is quite high.

Mitral insufficiency is a serious vice, so it is impossible to delay it to identify, diagnosis, treatment.

The main prevention measures of this pathology are aimed at preventing the development of complications. First of all, it is:

healthy patient's lifestyle;
moderation in food;
refusal of greasy and acute;
refusal of alcohol and smoking.

Primary prevention begins in childhood and includes elements such as hardening, timely treatment infectious diseases, including dental caries and inflammatory diseases Almonds.

Secondary prophylaxis is the reception of drugs that expand the vessels (vasodilators) improve the bloodstream, reduce blood pressure.

Mitral insufficiency can give relapse even after operational intervention. Consequently, you need to take care of yourself, take all the drugs prescribed by the doctor, to fulfill his advice.

Publication date of Articles: 05/22/2017

Date of renewal of Article: 12/21/2018

From this article you will learn: what is the insufficiency of the mitral valve, why it develops, as manifests itself. The degree of illness and their features. How to get rid of the lack of mitral valve.

The insufficiency of the mitral valve is its vice, in which his sash is not able to completely climb. Because of this, regurgitation occurs (reverse blood flow) from the left ventricle into the left atrium.

The disease is dangerous in what leads to, impaired blood circulation and associated disorders of the internal organs.

Valve vice can be fully cured with the help of surgical intervention. Conservative treatment - it is more symptomatic.

Cardiologist, cardiac surgery, rheumatologist are engaged in treatment.

The reasons

This acquired vice, not congenital. Its reasons may be diseases that damage the connective tissues of the body (since the valves consist of connective tissue), and the anomalies of the valve itself.

Possible causes of the defect of the mitral valve:

Systemic diseases	Heart disease	Valve anomalies
Rheumatism - a disease in which lymphocytes (immunity cells) attack the cells of the connective tissue of their own body	Myocardial infarction	- Tsp at one or both of his sash in the left atrium cavity
Red Volcanka - a disease in which antibodies produced by immune system, damage the DNA of the cells of the connective tissue.	Endocarditis (inflammation of the inner sheath of the heart)	Age degenerative changes in the mitral valve
Martan Syndrome - genetic diseasein which fibrilline production is broken 1 - structural component Connective tissue that gives it strength and elasticity.	Coronary artery disease
	Heart injuries

Symptoms, degrees and stages

The disease can occur in acute and chronic forms.

Acute Mitral Insufficiency occurs when the tendon chord is ruptured or papillary muscles during a heart attack or in infectious endocarditance, as well as heart injuries.

Chronic develops gradually (in 5 stages) due to chronic diseases, such as rheumatism, system red lupus, ischemic disease Hearts, as well as due to pathologies of the most mitral valve (its prolapse, degeneration).

Symptoms of acute disability of the double valve:

A sharp drop arterial pressure Up to cardiogenic shock.
Lack of left ventricle.
Sweep of the lungs (manifests itself by chopping, cough, wheezing, sputum release).
Atrial extrasystoles.
Atrial fibrillation.

The degree of mitral insufficiency

Determine the severity of the vice can be echocating (ultrasound of the heart). It depends on the volume of blood, which falls back to the left atrium, and on the size of the hole, which remains when the valve flap is closed.

Characteristics of severity:

Disease Stages: Characteristics and Symptoms

Depending on the severity of the vice, the severity of circulatory disorders and symptoms that are disturbed by the patient, 4 stages are disturbed:

Compensation Stage. It is characterized by the insufficiency of the mitral valve of 1 degree (the volume of regurgitation is less than 30 ml). Circulatory disorders and big circles No missing. The patient does not bother no symptoms. The disease can reveal randomly during a planned medical examination.
Stage of subcompensation. The degree of gravity in the indicators of EchoCG is moderate. Reverse blood flow into the left atrium leads to its expansion (dilatation). To compensate for circulatory disorders, the left ventricle is forced to shrink more intensively, which leads to its increase - hypertrophy. With intensive physical exertion, shortness of breath appears and reinforced heartbeat, which indicates a minor circulatory impairment in the pulmonary (small) circle. Possible small edema of the legs (stop and legs).
Stage of decompensation. The severity of regurgitation is 2-3. At this stage, blood circulation is disturbed both in small and in large circles. It is expressed by shortness of breath with any physical exertion, a significant increase in the left ventricle, a gulling, novel or stabbing pain in the left half of the chest (usually after exercise), periodic heart rate failures.
Dystrophic stage. The severity is the third (regurgitation more than 60 ml or 50%). The functioning of not only the left, but also right ventricles is broken. On echoca or an x-ray of the chest can be found hypertrophy of both ventricles. Significantly deteriorated blood circulation in both circles. Because of this, pronounced edema on the legs, pain both on the left and in the right hypochondrium (may occur both in peace), shortness of breath after a minor physical activity or alone, attacks (choking, cough). Renewing and liver disorders appear. At this stage, the insufficiency of the mitral valve may also be addicted to the tricuspid valve.
Terminal stage. Corresponds to the 3 stages of chronic heart failure. The functioning of all parts of the heart is broken. The heart is no longer enough to supply all organs with blood. Patient worried shortness of breath alone, frequent attacks Cardiac asthma, interruptions in the work of the heart, intolerance to any physical exertion, edema limbs and abdomen, pain in the heart, arrhythmia (atrial fibrillation,). Develop irreversible dystrophic changes in internal organs (First of all - kidneys and liver). The forecast is extremely unfavorable. Treatment is already ineffective.

Diagnostics

To identify the disease, one or more procedures apply:

ordinary echoca;
expressive EchoCG;
x-ray organs of the chest cavity;

Treatment

It can be surgical or drug. However, medication cannot be completely eliminated by pathology. It is possible to fully cure mitral insufficiency using the operation.

Tactics of disease treatment

For acute form Mitral insufficiency is emergency to remove symptoms, and then carry out operation.

In chronic form, treatment tactics depends on the stage.

Stage	Method of treatment
First Stage (Compensation Stage)	Surgical treatment in most cases is not shown. It is possible to appoint medicines.
Second stage (subcompensation stage)	It is possible both drug treatment and surgical (the greater regurgitation volume, the more necessary the surgical intervention).
Third stage (stage of decompensation)	Be sure to conduct an operation.
Fourth stage (dystrophic)	Surgical intervention is prescribed.
Fifth stage (terminal)	Incurable, as it leads to irreversible changes in the internal organs. It is possible to prescribe drugs to relieve symptoms, but this does not affect the further forecast and life expectancy.

Medicia treatment

Under the acute form of the disease to the patient, nitrates (nitroglycerin) and non-neutropic drugs (for example, dobutamine) are introduced as first aid. After that, the emergency operation is carried out.

In chronic form, treatment should be directed both to improve the work of the heart and blood circulation and to get rid of the underlying disease.

Diuretics, beta-adrenoblastors, aldosterone antagonists, nitrates, antiarrhythmic agents, ACE inhibitors are used to correct blood circulation disorders. If the risk of thrombosis is increased - antiagregants.

Treatment of the underlying disease that caused the pathology of the mitral valve:

Disease	Preparations
Rheumatism	Corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), antibacterial agents.
lupus erythematosus	Corticosteroids, NSAIDs, immunosuppressants, FNF inhibitors.
Martan Syndrome	Symptomatic for the prevention of cardiovascular complications: beta adrenoblocators.
Endocarditis	Antibiotics - as the main treatment; Cardiac glycosides and thrombolytics - to prevent the progression of cardiovascular complications.
Coronary artery disease	Statins, fibrates, natural hypolypidemic agents - for the impact on the pathological process; Nitrates, ACE inhibitors, antiarrhythmics, beta-adrenoblastors, antiagregants - against cardiovascular complications.

Captopril - Class representative of ACE inhibitors

Surgery

It is prescribed in the acute form of the disease, as well as at the second and above stage of chronic form.

In modern surgical practice, two types of operations are used:

Plastic valve. This is the reconstruction of its own valve (heaving his sash, tendon chord).
Valve prosthetics. This is its replacement for a prosthesis of artificial or biological origin.

After performing the operation on time, you can prevent further progression progression and cardiac failure associated with it.

Prevention

Preventive measures are in the treatment of the underlying disease before the onset of mitral deficiency (timely treatment of endocarditis with antibiotics, right reception prescribed by the doctor drugs during rheumatism, etc.).

Exclude factors that increase the risk of heart disease: smoking, alcoholism, frequent use of oily, salt and acute food, irregular drinking mode, lack of sleep, low mobility, obesity, stress, irrational distribution of labor and recreation time.

Life with mitral insufficiency

If the vice of the first severity is at the stage of compensation, it is possible to dispense only by the observation of the doctor and the reception of the minimum amount of drugs. Attend cardiologist and make echocrous every six months.

Physical activity within reasonable limits is not contraindicated, but competitive sports loads are excluded at any stage of vice.

As for pregnancy, then early stage Pulk without expressed circulatory disorders, it is possible, but the childbirth will be passed through cesarean section. With a disease 2 and above, a successful pregnancy is possible only after eliminating the vice.

After prosthetizing the valve, follow the rules healthy image Life for prevention cardiovascular diseases. If you need any operations in the future (including dental) or invasive diagnostic procedures, warn your doctor about the presence of a valve prosthesis, as you will assign special preparations To prevent inflammatory process and thrombosis in the heart.

Forecast

The forecast depends on the cause of vice.

In most cases, it is unfavorable, since the main diseases (rheumatism, lupus, Marfan syndrome, ischemic heart disease) is difficult to treat and cannot be completely stopped. Thus, the disease can lead to other lesions of the heart, vessels and internal organs.
If the vice was caused by endocarditis or degenerative changes In the valve itself, the outlook is more comforting. Curation is possible in the case of a timely operation of a plastic or valve prosthetics. The set prosthetic will serve from 8 to 20 years and more depending on the species.
The forecast for vicious 1 gravity, which is not accompanied by circulatory disorders, can be favorable. With proper tactics of observation, as well as in the treatment of the underlying disease, mitral failure may not progress for many years.