Mitral valve prolapse
Mitral valve prolapse - a common heart disease, which is characterized by protrusion of one and / or both of the valve leaflets into the left atrium when the left ventricle contraction.Mitral valve prolapse is seen in 15 - 20 percent of the people are much more likely to suffer female.Typically, this pathology occurs without any symptoms, therefore defect is detected at preventive examinations.
Diagnosis Mitral valve prolapse is often in adolescence and young age (14-30 years).Experts identify the primary and secondary prolapse.Primary due to genetic defects and disorders of the connective tissue of the heart.Secondary prolapse usually develops on the background of various illnesses, and leading role in shaping blemish play rheumatic diseases, inflammation of the heart muscle, traumatic injuries of the chest.
mitral valve prolapse causes
To understand how and why developing mitral valve prolapse, need to know how the heart valves are functioning normally.
human heart - pump, stimulating blood circulation through the blood vessels.This process is possible by maintaining a constant pressure in every department of the heart.This body a person has four chambers and valves - special valves that help regulate blood pressure and blood flow in the desired direction.Valves as much, and the cameras - four (mitral, tricuspid, pulmonary valve and the aortic valve).
mitral valve in the position between the left atrium and ventricle.Each flap valve mounted thin chord, which are attached to the second end of papillary and papillary muscles.To the valve to function properly, it requires coordinated synchronous operation of muscles, leaflets and chords.During systole the pressure in the chamber is significantly increased.Under the influence of this force the valve opens its wing, and the level of disclosure control papillary muscles and thread-chord.The blood flows from the atrium through the mitral valve opening, report it to the ventricle and from the ventricle through the aortic valve in the aorta.To while reducing the ventricular blood is not moving in the opposite direction, the mitral valve closes.
With mitral valve prolapse observed his bulging at the time of closing.This leads to insufficient clamping flaps, and a small amount of blood is thrown back, i.e. to the left atrium.Such a phenomenon in scientific language sounds like "regurgitation."In the vast majority of known cases of valve prolapse is accompanied by a very slight regurgitation and does not cause serious disruptions in the functioning of the heart.Prolapse can occur for two reasons: a birth defect, passed from parents inherited and prolapse after diseases.
Congenital mitral valve prolapse in most cases is caused by underdevelopment of connective tissue flaps.Due to the fact that the connective tissue is defective and weak, easily stretched flaps and heavier return to original form, that is, become less elastic.For this reason, the chord is gradually lengthened.That is why after the release of blood flap can not close until the end, there is a return throw blood.Such a small defect often leads to the appearance of unwanted symptoms or unpleasant symptoms.That is why congenital mitral valve prolapse is more of individual characteristics of the child than a pathological condition.
much rarer mitral valve prolapse, initiated by various diseases.Prolapse, occurs due to rheumatic heart muscle, often found in infants and school-age children.It is caused by widespread inflammation in the connective tissue of the valve leaflets and thread-chords.In most cases, such prolapse is preceded by prolonged heavy flowing sore throat, scarlet fever or flu.The period of convalescence the child has an attack of rheumatic fever, against which starts the formation of prolapse.That is why it is important to recognize the beginning rheumatism in his characteristic symptoms: fever, pain in the joints, and increase their stiffness.
Mitral valve prolapse may develop in older people.The reason in this case becomes ischemic heart disease.Myocardial infarction may also trigger the development of this pathology.The main reason - the deterioration of blood supply papillary muscles or break threads.In this case, mitral valve prolapse is detected on the basis of the characteristic symptoms and complaints, which will be described below.Post-traumatic prolapse is characterized by a poor outcome if you do not start early treatment of this pathology.
Mitral valve prolapse symptoms
mitral valve prolapse, available in a child with a birth, almost always combined with vascular dystonia.That it causes most of the uncomfortable symptoms, not the prolapse, as is commonly believed.
The child may experience periodic short-lived pain in the heart, sternum, in the upper quadrant.They are not associated with vice, and in violation of the nervous system.Often, these unpleasant sensations arise after a nervous shock, strong emotions and rarely without a provoking factor.They usually last from several seconds to several minutes.In rare cases, the pain may persist for several days.You should know that the pain of mitral valve prolapse do not become harder during exercise, it is not accompanied by shortness of breath, dizziness and fainting.If the pain is accompanied by the above symptoms, you should immediately go to the hospital, because we can talk about organic heart disease.
Another symptom associated with increased lability of the nervous system - heart attacks with a sense of "fading."Here, too, there is an important feature: tachycardia during mitral valve prolapse begins suddenly, and as suddenly ends without being accompanied by bouts of fainting or nausea.Prolapse may also be accompanied by a number of other symptoms: low-grade fever in the evening, pain in the small and large intestine, headache.
People with mitral valve prolapse, resemble each other: they are often asthenics have thin upper and lower limbs, high mobility in the joints.Connective tissue is available and in the muscles, skin and tendons.That is why often connected with vice diagnoses such as strabismus, deterioration of visual acuity.
Often mitral valve prolapse is diagnosed during ultrasound diagnosis.This method is likely to give the opportunity to determine the degree of prolapse arisen and cast the blood level of return.
Mitral valve prolapse degree
Doctors are three degrees of mitral valve prolapse.
Mitral valve prolapse is characterized by 1 degree small protrusion of the leaflets, not exceeding five millimeters.
With mitral valve prolapse 2 degrees bulging has already reached nine millimeters.
With mitral valve prolapse degree of protrusion of 3 wings exceed ten millimeters.
These degrees are conditional because the level of blood casting they do not affect, in other words, when mitral valve prolapse 1 degree, regurgitation may be greater than three.Therefore, more attention should be paid exactly the degree and level of casting valve insufficiency, the physician determines individually during ultrasound diagnosis.
In case ultrasound diagnosis was not sufficiently informative, the doctor may prescribe other methods of research, such as electrocardiography or Holter electrocardiography.
Holter ECG will provide an opportunity to dynamically determine violations caused by failure of the valve, and to determine the degree of mitral valve prolapse, because the device will record any changes in the functioning of the heart throughout the day.
In most cases, hereditary prolapse or ultrasound diagnosis or Holter electrocardiography show no rough life-threatening hemodynamic disturbances.Determine the degree of circulatory disorders caused by mitral valve prolapse, can a doctor who knows the complete history of the disease and having the results of all diagnostic methods.If the disease was discovered quite by accident, during the examination of other organs and systems, and do not disturb the patient no symptoms and unwanted symptoms such deviation is taken as the version of the rules and does not need treatment.
Mitral valve prolapse in children
Children mitral valve prolapse is found in 2-14% of all cases.It can be as isolated defects, and combined with certain somatic pathologies.
Quite often in children with this disease goes dizraficheskimi stigmas (small anomalies of the heart).These stigma talk about congenital underdevelopment of connective tissue.Isolated prolapses divided into two forms: silent (ie listening phonendoscope any changes will not be detected), and auscultation (the doctor hears shelchki and noise).
More often mitral valve prolapse in children detected until about fifteen years, but possibly a late diagnosis.
auscultation form is found in the vast majority of girls.In the early history of a problem is detected with prolonged pregnancy preeclampsia, the threat of disruption.Often, the mother who gave birth to a child with mitral valve prolapse birth was also complicated.Have relatives baby is often found disease ergotropic circle.In such families prolapse was diagnosed in twelve to fifteen percent of the children on the maternal side.
A careful study of pedigree you can find family illnesses associated with connective tissue disorders.These diseases include varicose veins, various hernia and scoliosis.Typically, a child with mitral valve prolapse is very common to find negative psychosocial environment, that is, in the family and the school are constant quarrels and conflicts, he becomes a witness.
child with mitral valve prolapse often healthy children suffering from acute respiratory diseases, chronic inflammation of the tonsils and sore throat.
Children with isolated mitral valve prolapse often impose such complaints: a sense of failure in the rhythm of the heart, pain in the chest, in the heart, rapid heart rate, feeling short of breath and dizzy in the morning, after the psycho-emotional turmoilor loads.As for patients with vascular dystonia, they are characterized by headaches, tendency to faint.
heartache in children with mitral valve prolapse have a number of characteristics: they are aching or stabbing, do not apply to other areas, short, occur after nerve shocks.The child may be dizzy with rapid change in body position (with a sharp rising) or long break between the meal.Headaches often disturbed in the morning or after a stressful situation.These children are quick-tempered and nervous, do not sleep at night, often waking up.
Besides US and Holter ECG child with mitral valve prolapse should study the autonomic functions of the nervous system and psychological tests.On examination of the child's attention is drawn to such features of dysplastic type of structure is flattened chest, fatigue, poor muscle development, high growth, a little age-appropriate, high mobility in the joints.Girls in most cases blond hair and eyes.Can be detected at inspection and other related stigma: muscular hypotonia, a flattening of the feet, gothic sky, long thin fingers, myopia.There may in rare cases more serious violations of: funnel-shaped chest, multiple hernia (inguinal, umbilical, inguinal-scrotal).In the study of the emotional sphere is possible to diagnose high lability of mood, tearfulness, anxiety, short temper, fatigue.
If the child has developed a vegetative paroxysm that happens quite often, he starts suffering from various fears, phobia is often the fear of death.The mood of these patients is extremely volatile, but still plays a leading role depressive and depressive-hypochondriacal condition.
study functions of the autonomic nervous system is of great importance.Usually these children sympathicotonia prevails.At a high level, prolapse of the leaflets that accompany holosystolic noise while listening, may show symptoms prevalence parasimpatiki against the backdrop of increased activity of catecholamines.When combined with vagal hypertonus hypersympathicotonia and gipervagotoniey, it can cause tachyarrhythmias, life-threatening.
auscultation form of mitral valve prolapse is subdivided further into three forms.The criterion is the degree of severity and clinical manifestations.
At first degree cardiologist listens only isolated clicks.Small malformations or absent, or occur to a small extent.When this disease infringed general adaptation ability of the autonomic system to the mental and physical stress.
The second type has a number of the above symptoms and detailed clinic.On echocardiography determined prolapse pozdnesistolicheskogo character.Folds protrude moderately - five to seven millimeters.Status characterized sympathicotonic vegetative shifts vegetative support activities manifested in abundance.
third type is characterized by severe abnormalities in the data obtained from the instrumental studies.The examination is determined by a large number of small anomalies, auscultation - pozdnesistolicheskie noise.An echocardiogram provides information about the presence of holographic or pozdnesistolicheskogo prolapse is large enough depth.Exploring the autonomic tone, you can identify the prevalence parasimpatiki but mixed version can also be found.There is increased autonomic activity, provide redundancy.These patients are characterized by the highest degree of maladjustment to physical stress.
Based on the foregoing, it can be concluded that the level of dysfunction of the valve depends on the degree of vegetative-vascular dystonia.
mute option of mitral valve prolapse is diagnosed with equal frequency in both sexes.The early history also includes the complications of pregnancy, frequent colds, which contributes to the development of both prolapse and VSD.Clinical symptoms and deviations in instrumental studies are often lacking, that is, these children are actually healthy.If a child has complaints of severe fatigue, mood swings, headaches, and heaviness in the stomach, it confirms the concomitant prolapse dystonia.
small anomalies can be present but the total amount will generally not exceed five.Small anomalies combined with satisfactory physical development that meets all the standards.
nervous system in children with this form of mitral valve prolapse is also characterized by a certain variability, sometimes manifested dystonia, more often mixed version or parasympathetic.In some cases, children with this disease can happen valve panic attacks.But do not forget that they happen and perfectly healthy children with increased excitability of vegetative division of the National Assembly.That is why a special impact on the lives and well-being of the child does not have these attacks.
Children with this rejection often have adequate vegetative support, in rare cases, it may be slightly reduced.Thus, when veloergometry performance indicators in children with dumb prolapse actually no different from that of physical health.