What is it, and what is it dangerous? The prolapse of the mitral valve( PMC) is a fairly common pathology of the heart valve.
Sometimes this disease is called a "click and noise syndrome" because of the characteristic sounds that the heart valve emits during operation.
Doctors far from unequivocally relate to this pathology. On the one hand, the PMK prognosis is quite favorable, but with concomitant heart disease, PMC can lead to some complications.
What is a heart valve?
To better understand the nature of mitral valve prolapse, it is necessary to understand the purpose of the heart valves and their structure. In general, the heart valve is an internal fold or plate that provides a unidirectional blood flow.
The heart consists of four chambers: the right and left atria, the right and left ventricles. Between the atria and the ventricles are four valves, each of which provides the direction of the blood flow in a certain direction.
The mitral valve is located between the left atrium and the left ventricle of the heart. It is a two-leaf valve, that is, consisting of two valves, which prevent the blood from getting back into the left atrium in the process of contracting( systole) of the left ventricle.
How does the valve work normally and with prolapse?
In normal operation of any valve, blood enters the ventricles or atria without any difficulties. Healthy valves should not be narrowed, which is typical in case of their stenosis. Also, they should not allow blood to flow back to the atrium, which is typical for valve failure.
With a mitral valve prolapse, its structure is disrupted. This violation is expressed in the fact that one of the valves of the valve bends or protrudes into the area of the atrium. This leads to the fact that with the contraction of the ventricle, part of the blood escapes back to the atrium.
If the amount of return blood is small, the pathology usually does not affect the person's health in any way and most often he does not need treatment. But if the pathology is extensive and the amount of returnable blood is large, careful diagnosis, therapy, and in some cases, surgical treatment, is required.
It should be noted that PMC is divided into:
The emergence of primary MVP is associated with heredity. As a result of changes in genes, there is a disruption in the production of normal connective tissue. As a result, the valve flaps significantly thicken and there is a "protrusion" followed by an incorrect outflow of blood.
Secondary PMC occurs against a background of various diseases, for example, against systemic lupus erythematosus, coronary heart disease, myocardial infarction, cardiomyopathy, congestive heart failure, rheumatic fever, etc.
Also read the symptoms and treatment of mitral stenosis.
Symptoms of mitral valve prolapse
Mitral valve prolapse most often found in children and adolescents aged 7 to 15 years, as well as in adults under 30 years.
And cases of PMC in women are diagnosed twice as often as men, and in children and adolescents the difference is not very pronounced.
More than half of people with PMC do not have any specific symptoms. Prolapse is thus diagnosed accidentally and in most cases does not require treatment or continuous monitoring.
Common symptoms of mitral valve prolapse can be considered moderate pain or discomfort in the chest, the appearance of which is usually associated with the physical activity of a person, psychoemotional stress or overwork. Also, doctors distinguish the relationship of PMC with a predisposition to colds, tonsillitis and chronic tonsillitis.
Given that women are more likely than men to suffer from PMC, their clinical manifestations are more pronounced. So, women can suffer from nausea, excessive sweating, and in case of serious physical or emotional stress, bordering on overstrain, there may be a vegetative crisis.
A fairly frequent symptom of PMP is arrhythmia, which manifests itself in a rapid heartbeat, a sensation of tremors and irregularities in the work of the heart. A similar condition occurs due to excitement, physical activity or the use of strong tea, coffee and energy drinks. In addition, in 25% of cases there is a syndrome of elongated QT, which, however, rarely manifests itself.
A very vivid general symptom of PIC is a variety of psychoemotional disorders. Often, patients seek medical help precisely because of such deviations. The most common are depressive states with a bias in hypochondriacal experiences. Man is haunted by sadness, indifference to external irritants, unreasonable longing, and sometimes anxiety and excessive irritability.
General fatigue and weakness, which often accompany such conditions, pass after a short rest. Sometimes a person can feel deterioration in the evening, which is explained by the development of senestopathy - a painful and unpleasant feeling on the surface or inside the body, in the organs, without objective reason.
It can be seen that there are quite a few symptoms of PMC, but there are few specific symptoms that would accurately indicate the presence of pathology.
Each of the above symptoms may refer to another disease, which has nothing to do with PMC.That's why diagnosing PMC on symptoms is extremely difficult. The risk of error in this case is quite high.
Certain information can be provided by the presence of specific signs of PMC.As already mentioned, the prolapse of the mitral valve is sometimes called the "click and noise syndrome", which is not a beautiful medical invention. People with valve pathology often hear clicks or clicks while working the heart, which are explained by excessive stress chords. Sometimes it is determined by a holosystolic murmur. It is constant and does not change in different positions of the body.
Treatment of mitral valve prolapse 1, 2 and 3 degrees
Mitral valve prolapse is diagnosed most often by accident. Since the symptoms of PMC are typical for many other diseases, echocardiography( Echocardiography) is used to detect prolapse. It allows you to see the full picture of the disease and determine its degree. Thus, mitral valve prolapse is divided into:
1 degree, which is characterized by bulging valve leaflets no more than 5 mm.
2 degree, in which the bulging is within 8 mm.
3 degree, which is characterized by bulging of the valve by 9 mm or more.
It is believed that patients with PMD of 2 and 3 degrees are at increased risk of complications.
For diagnostic purposes, the electrocardiographic method( ECG) of the study is also used. It helps to identify malfunctions in the rhythm of the heart, bradyarrhythmia, tachycardia. In most cases, for patients without complaints of the heart, concomitant diseases and mitral valve prolapse, the first degree of ECG is not performed, limited only to regular echocardiography for the purpose of annual monitoring of the heart.
In rare cases, an x-ray examination of the chest can be performed, which will reveal any deviations in the structure of the chest. Such deviations can seriously affect the work of the heart and about PMC in this way can be said as acquired, that is, secondary.
Mitral valve prolapse of not high degree with absence of complications does not require treatment. In the case of patient complaints of pain or discomfort in the chest, as well as the results of ECG and EchoCG, which showed characteristic cardiovascular changes, adequate treatment should be prescribed.
First of all, close attention to the patient should be given to the normalization of working and rest time, the formation of proper nutrition and the organization of regular physical activity.
The frequency of physical activity and possible sports, which will not harm a person with PMC, can only tell the doctor.
Each patient in the treatment of PMP requires an individual approach, taking into account the characteristics of his condition, concomitant diseases and lifestyle. So, physiotherapy, water procedures and therapeutic massage aimed at improving the state of blood vessels and heart can be prescribed. In the treatment of PMK, magnesium, as well as preparations that improve metabolic processes in the myocardium, has proved to be a good candidate.
In the event that the manifestation of symptoms of PMC occurs after stress, psychoemotional stress, and also in the case of development of depression on the background of prolapse, taking sedatives or antidepressants is required.
Surgical treatment of PMC is extremely rare. The disease should be 3 degrees, marked by complications and severe malfunctions in the heart, so that surgical treatment is prescribed.
Possible complications of
With age, the risk of complications with PMP increases, but, nevertheless, a real exacerbation of the disease is observed only in 5% of cases. With PMC, the following complications are possible:
1) Mitral insufficiency. It manifests itself in sudden pulmonary edema, arrhythmia develops. The person will hear rattles in the lungs and bubbling breath. If mitral insufficiency goes into a chronic form, the symptoms will not be so pronounced. There will be complaints of shortness of breath after physical exertion, reduced efficiency and endurance.
2) Infective endocarditis. The disease occurs as a result of the defeat of the heart valves by pathogenic bacteria, for example, staphylococci, streptococci or enterococci. It is difficult to identify the relationship between PMP and infective endocarditis, but it is known that the pathogenic flora deposits on the altered valve plates, causing an inflammatory process.
3) Neurological complications. Expressed in the development of thromboembolism resulting in the emergence of microthrombi due to PMC.
In addition, there are cases of sudden death with mitral valve prolapse. These cases are extremely rare and develop in the presence of serious arrhythmias and the syndrome of an extended QT interval.
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