Mitral insufficiency: Causes and Therapies
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Mitral insufficiency — is a defective closure of the mitral valve that closes during systole the left atrium from the left ventricle. As a result, during the contraction of the heart of the blood is returned to the atrium. Long time no defect manifests as heart partially compensates the load alone. As the load on the heart arises clinical symptoms blemish.
Mitral insufficiency: Causes
Mitral insufficiency may be congenital, which is rare, and the acquired character. The main reasons can be acquired blemish:
- atherosclerotic lesions,
- tuberculosis and syphilis, infectious processes,
- arterial hypertension,
- myocardial infarction,
Many of the causes are not damage the valve itself, but leads to expansion of fibrous ring area, so that they can not fully interlock. Formed a relatively (or functional), mitral insufficiency. During the operations improves the condition of patients, but these defects are very common complications of thromboembolism.
Mitral insufficiency: Degrees failure
When mitral insufficiency of the first degree of blood return does not exceed 15% of the volume. When the second power return blood volume is from 16 to 30%, while the atrium is not expanded. When third-degree blood return up to 50% of the volume, while the left atrium moderately expanded. In the fourth degree of blood return is more than 50%, greatly expanded atrium.
Mitral insufficiency: Clinical manifestations
Symptoms of mitral insufficiency in the early stages may not occur. Eastern Promises is compensated by the inclusion of specific compensatory mechanisms of the heart and blood vessels. With a sharp increase in blood return reset back to the atrium and the left ventricle there is increasing formation of pathological reflexes. In response to the increase in blood pressure in the left atrium occurs spasm of arteriolar pulmonary circulation — reflex Kitaeva. This can produce symptoms:
- shortness of breath during exercise, is characteristic of the later stages of the disease due to the stagnation of blood in the lungs,
- dry and non-productive cough, is not amenable to treatment,
- coughing up blood, a symptom of extreme running blemish
- weakness, fatigue, swelling, pain in the heart, liver enlargement.
Mitral insufficiency: Diagnostics
The basis of diagnosis — examination of the patient and his typical complaints, but in the early stages, patients may not have complaints and defect detected instrumentally. What is important is a full examination of the heart and determination of boundaries, careful listening to tones and heart murmurs, heart study.
In the future held:
- chest X-ray,
- ECG diagnosis,
- ECHO kg doplerometrii,
- cardiac catheterization cameras with measurement of pressure in them,
- ventriculography of the left heart.
Mitral insufficiency: Therapies
Provided conservative and surgical treatment of heart diseases. By resorting to conservative therapy for inoperable lung defect or blemish during the relative compensation. Used diuretics drugs, vasodilators, antibiotics for infectious nature of vice. In severe mitral regurgitation can be used IABP without rupture of the papillary muscles.
When surgical treatment is performed valve replacement or surgery to repair their anatomical integrity. The operation is open-heart surgery with cardiopulmonary bypass. Current operations are carried out not always to cut the sternum — can be less traumatic operation.
Mitral insufficiency: Forecast
The prognosis of mitral insufficiency relatively favorable. With the help of medication can be a long time to maintain a normal state of health. Modern cardiac surgery actively corrects severe malformations, which allows the patient to live a long time.