Prolapse of the mitral valve

The mitral valve is presented by the front and back connective tissue shutters having an appearance of flat leaflets. Strong chords (threads) of a shutter fasten to papillary muscles, and papillary muscles are attached to a bottom of a left ventricle of heart. In a phase of relaxation (diastole) of a shutter of the valve cave in down. Blood from the left auricle freely moves to a left ventricle. In a phase of a systole of a shutter of the valve rise, closing an entrance to the left auricle.

Prolapse of the mitral valve – sagging of shutters (one or both) in an auricle cavity. For the first time this phenomenon was described during emergence of a method of an echocardiography (in the sixties). This pathology can be diagnosed at any age, but most often it is revealed at children is more senior than seven years.

Pathogeny and etiology of a prolapse of the mitral valve

Depending on an origin the prolapse of the mitral valve is divided on idiopathic (primary) and secondary. Primary prolapse arises at a dysplasia of connecting fabric. The dysplasia of connecting fabric leads to change of structure of papillary muscles and the valve, distribution disturbance, the wrong attachment, shortening or lengthening of chords, emergence of additional chords.

The secondary prolapse of the mitral valve usually accompanies and complicates hereditary syndromes (an inborn kontrakturny spider finger, an elastic pseudoxanthoma, a syndrome of Elersa-Danlo-Chernogubova, Marfin's syndrome), and also endocrine pathologies, rheumatic diseases, heart diseases. The secondary prolapse of the valve can develop at the acquired myxomatosis, inflammatory damage of valve structures, a valve and ventricular disproportion.

The prolapse of the mitral valve can develop owing to dysfunction of the autonomic nervous system, disturbance of metabolism and deficit of microelements, in particular potassium ions and magnesium

Discrepancy or leaky smykaniye of shutters of the valve is followed by emergence of systolic noise of various intensity. At the same time the mesosystolic clicks arising at an excessive tension of chords are auskultativno registered.

Depending on the size of protrusion of shutters of the valve allocate the following degrees of a prolapse of the mitral valve:

• first degree (from 2 to 3 mm);
• second degree (from 3 to 6 mm);
• third degree (from 6 to 9 mm);
• fourth degree of a prolapse of the mitral valve (more than 9 mm).

Course of this disease usually high-quality, long, favorable. Dysfunction of the device of the valve usually progresses slowly. At one patients throughout all life the state remains stable, and at other patients with age the given pathology of the valve can decrease or disappear.

Symptoms of a prolapse of the mitral valve

Symptoms of a prolapse of the mitral valve depend on expressiveness of vegetative shifts and a connective tissue dysplasia. Patients with this disease most often complain of increased fatigue, heartbeat, dizziness, headaches, the lowered physical effeciency, interruptions in cardiac performance, psychoemotional lability, irritability, a hyperexcitability, pain in heart, uneasiness, hypochiondrial and depressive reactions.

Various displays of a dysplasia of connecting fabric are characteristic of this disease: the reduced body weight, the increased elasticity of skin, hyper mobility of joints, scoliosis, deformation of a thorax, flat-footedness, a myopia, alate shovels. It is also possible to find a nephroptosis, a sandalevidny crack, a peculiar structure of a gall bladder and auricles, a giperterolizm of nipples and eyes. Quite often at a prolapse of the valve observe change of arterial pressure and heart rate.

Diagnosis and treatment of a prolapse of the mitral valve

For diagnosis of a prolapse of the valve use tool and clinical methods. Diagnosis is promoted given the anamnesis, the complaint, by results of a X-ray analysis and ECG, display of a dysplasia of connecting fabric. Diagnostic methods allow to reveal this pathology and to differentiate it from the acquired or inborn insufficiency of the mitral valve, other options of anomalies of development of heart or dysfunction of the valve device. By results of EhoKG it is possible to estimate correctly revealed cordial changes.

Tactics of treatment of a prolapse of the mitral valve depends on degree of a prolapse of shutters of the valve and volume of regurgitation, and also the nature of cardiovascular and psychoemotional disturbances. At this disease it is necessary to pay attention to a sufficient (long) dream. The question of sports activities is usually considered by the attending physician after assessment of indicators of physical fitness. Patients with a prolapse without the expressed regurgitation can lead active lifestyle without any restrictions.

Phytotherapy – an important component in treatment of a prolapse of the valve. This type of treatment consists in reception of the calming (sedative) drugs on the basis of a motherwort, a valerian, a Labrador tea, a hawthorn, a St. John's Wort, a sage. Medicamentous therapy is directed to a symptomatic treatment of displays of a disease.

Sewing up of the struck mitral valve (valvuloplasty) is carried out at the expressed regurgitation and a circulatory unefficiency. At inefficiency of valvuloplasty replacement of the struck valve with an artificial analog is made.

Complications of a prolapse of the mitral valve

Insufficiency of the mitral valve – quite frequent complication of rheumatic damage of heart. The incomplete smykaniye of shutters of the valve and their anatomic defect promote considerable return of blood to an auricle. The patient is disturbed by an asthma, weakness, cough. At development of a similar complication prosthetics of the struck valve is shown.

Complications of a prolapse of the mitral valve can be shown in the form of attacks of arrhythmia and stenocardia. These complications can be followed by disturbance of a cordial rhythm, dizziness, faints.