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Mitral Valve Prolapse - Diagnosis, Treatment.
Mitral Valve Prolapse - Diagnosis, Treatment.
Prolapse of the mitral valve (mitral valve prolapse, MVP) strictly speaking, not a disease. This so-called clinical-anatomical syndrome.
Mitral valve consists of two large wings, which are flat leaves of the connective tissue. Strong threads (chords) are attached to the papillary muscles, which in turn are attached to the bottom of the left ventricle of the heart. In the phase of diastole (relaxation), mitral valve sag down, allowing blood from the left atrium to move freely into the left ventricle. In the systole phase of the pressure of blood in reducing left ventricular valve lift and close the entrance to the left atrium.
Prolapse (prolapse), mitral valve - a protrusion of one or both of its wings into the cavity of the left atrium. At the same time the entrance to the left ventricle may be closed completely or it may form an opening through which a small amount of blood can be moved back from the left ventricle into the left atrium. This phenomenon is called "mitral regurgitation". Depending on the amount of regurgitation is returning blood from 1 to 4 degrees.
It was suggested that many classifications of mitral valve prolapse (MVP). To date, PMC are usually divided into two groups:
Anatomic MVP PMC as a syndrome associated with a violation of the nervous and endocrine systems.
By anatomical PMC PMC is a primary, the most common. This is a congenital disorder in which the inherited developmental disorder of connective tissue. These patients are usually asthenic physique, have abnormalities in the musculoskeletal system (spinal scoliosis, flat feet, Krivolapov, relaxation of ligaments). Complaints of patients with mitral valve prolapse - chest pain, heart pain, shortness of breath, weakness, seizures, heart or interruption in the heart. Pain in the heart often dull, aching, and sometimes stabbing. They do not last long and are usually not associated with physical activity. Nitroglycerin does not improve, but rather may worsen the condition.
A significant proportion of patients have no pain associated with heart. It could be muscle pain, irradiation of the gastrointestinal tract or the spine. Shortness of breath and weakness they have is usually a manifestation of dysfunction of the nervous system.
Heart rate and disruptions in the heart can be as subjective feelings, and expression of cardiac arrhythmias associated with BMD. Sometimes, when a high degree of mitral regurgitation, there may be attacks of paroxysmal tachycardia when heart rate reaches 150-200 beats per minute. Often the mitral valve prolapse is accompanied by disorders of the nervous system. This is a migraine headache (attacks of severe headaches on the right or left side of the head), syncope, or fainting, mood changes, vegetative crises, panic attacks, psycho-emotional disorders. Sometimes the valve prolabirovannom deposited platelets and other blood cells, blood clots are formed, or myxomatous (gelatinous) proliferation. They can tear off small pieces of blood flow to the brain and cause small infarcts (strokes) of the brain.
Diagnosis of mitral valve prolapse is based on auscultation (listening) of the heart, when the detected systolic murmur. Changes in the electrocardiogram is not possible to establish the diagnosis of PMC. The main method for diagnosing mitral valve prolapse is echocardiography. By means of echocardiography can determine the amount of reverse blood flow (degree of regurgitation), the presence of myxomatous growths, the magnitude of the leaflets bulge in millimeters:
A degree of from 2 to 3 mm Grade 2 to 3 mm under6 Grade 3 from 6 to 9mm Grade 4 to 9 mm.
Increased risk of cardiovascular complications, patients with MVP are more than 3 mm, with myxomatous degeneration of valve leaflets.
During the PMC is usually a long, benign, beneficial. Violation of the mitral valve apparatus function progresses slowly in some condition remains stable throughout life, some with age, BMD may be reduced or disappear.
Treatment Mitral Valve Prolapse
In most cases, mitral valve prolapse - a random finding during examination for other complaints, and usually no treatment is required. If a patient complaints of neurological used therapy, hydrotherapy, massage, acupuncture. If there are episodes of loss of consciousness, cardiac arrhythmias, there are indications of sudden death from coronary heart disease have a close family member appointed by the cardioselective beta-blockers (atenolol, metoprolol, sotalol) or nonselective (propranolol) for a long time from 5 to 12 months, preparations containing magnesium. In the presence of neurotic disorders used tranquilizers and sedatives.
