Mitral valve insufficiency is a heart defect, when the mitral valve is unable to pump out the blood from the heart. Mitral insufficiency is the most common form of all valvular disorders. Every sixtieth patient with heart disease has mitral valve insufficiency. Usually people with insufficient mitral valve also develop the mitral narrowing, which is a narrowing process of the right atrioventricular orifice.
Patients with insufficient mitral valve can also feel dizziness in the morning or before the sleep and their heartbeat may become unstable due to the disruptions in the heart rhythm.
There are two types of this insufficiency: congenital and acquired. Congenital mitral insufficiency may be caused by adverse factors, which were accumulated during pregnancy. Such adverse factors include smoking, alcohol consumption, infections and polluted environment. Acquired insufficiency of the valve can be result of trauma or tumor. It can also be provoked by rheumatism or infectious illness called endocarditis, which is a malformation of the inner lining of the heart.
First of all a doctor conducts an analysis of medical history and patient`s complaints. Then he needs to know if the patient has relatives who suffered from heart diseases to see if patient has genetic predisposition. Physical examination includes auscultation (thorough listening to the heart) through a special device. If a doctor detects a mitral valve insufficiency murmur, he requires patient to have analysis of blood to see if there is any inflammation process or associated diseases. The blood test also determines the level of cholesterol, blood sugar and creatinine.
The most important diagnosis of insufficient mitral valve is electrocardiography, which assesses the rhythm of heartbeats and detects the presence of cardiac arrhythmias. In order to diagnose insufficient mitral valve, a doctor inspects both atriums and ventricles with ECG.
Phonocardiogram for mitral valve demonstrates the presence of systolic noise in the projection of valve.
Echocardiography of the heart is the main method of determining the state of the mitral valve. It can also estimate the parameters of heart chambers and the thickness of its walls, the condition of the other heart valves and the presence of fluid in the pericardium.
Usually the disease mitral valve is accompanied by similar disease, called mitral valve prolapse. It means there is a bulging of one or both heart valves, that separate atrium of the left side from the ventricle. This common disorder happens among 10-15 percent of the population. Women have it more often than male population. Prolapse is usually detected in young people between 15-30 years old. There are primary and secondary mitral valve prolapse syndromes. Causes of primary prolapse are hereditary or congenital diseases of connective tissue of the heart. The predisposition for secondary mitral valve prolapse is the same as for insufficiency: rheumatism or inflammation process of the heart. Sometimes it may be provoked chest injuries.
Most people have no symptoms of mitral valve prolapse. In rare cases a person may complain of pain in the heart, which is usually occurring when a person is emotionally moved or when he conducted some kind of physical activity. Pain during such manifestations of mitral valve prolapse is usually not excruciating, but it can be long and it can be accompanied by anxiety. Patients with mitral valve prolapse can also feel pain in the left chest side and lack of air. If that`s the case a person feels a need to take a deep, full breath. Such need may occur when a patient exercises or when he feels anxious. It happens because there may be not enough oxygen in the system of the person because of the problem with valves. He can also experience frequent palpitations or, on contrary, a very slow heartbeat. If the heartbeat is slow, a patient feels dizziness and he can develop anemia in a long run. In most cases, mitral valve prolapse does not present any serious danger and it can be treated well. Mitral valve prolapse sometimes causes a mild systolic murmur which is discovered during echocardiography. At a mild stage of mitral valve prolapse no treatment is required. If disease manifests itself in pain and arrhythmia, patient may be prescribed beta-blockers. In extremely singular cases, surgery may be required. Mitral valve prolapse is very characteristic for patients with insufficient mitral valve, because of the pressure which develops when the heart valve is unable to pump out the blood. People with mitral insufficiency should be very cautious of the possibility of developing this prolapse. Even if they have a mild case of mitral valve insufficiency, they need to be checked at cardiologist very often.
If a person has mild mitral valve insufficiency, he does not require any special treatment. In exceptional severe cases a patient needs to undergo surgical treatment. The most common type of surgery for this heart defect is replacement of mitral valve. Generally, the replacement can be done by implanting either the biological prostheses (using aorta of animals) or mechanical valve (made of special medical alloys). Biological prostheses are mostly performed for women who plan on pregnancy in future and children, whose heart would not be able to get used to mechanical valve. After implantation of mechanical prosthesis patient requires constant administration of drugs, which can reduce blood clotting by blocking the synthesis of liver substances that create blood clots. After implantation of biological prosthesis the postoperative therapy takes only one or two months.
A surgeon can also perform a mitral regurgitation, when an annuloplasty ring (plastic valve) in inserted into the heart at the base of the leaflets of the mitral valve. This ring supports the internal muscles of the heart, providing valve movement. Surgical treatment is contraindicated if there are irreversible comorbidities, which can lead the to death in the near future.
Complications that may possibly arise in future after the regurgitation and valve replacement
If a person was not diagnosed timely, he can develop cardiac arrhythmia and atrial fibrillation, which is a disturbance of heart rhythm. Patients with the disease, described above, can also have atrioventricular block, when electrical impulses of the heart become dysfunctional.Hide
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