Stenosis of the mitral valve is a disease of the heart, in which the left atrioventricular aperture is narrowed. This pathology refers to one of the most common forms of heart disease. The disease leads to a disruption of the diastolic blood flow, which is fed from the left atrium to the left ventricle. Pathology can be in isolated form, and only in the designated area, but there are also cases of damage to other valves.
According to statistics, most cases of stenosis of the mitral valve occur in women. Out of 100,000 people, it occurs in 80 people.
Symptoms are manifested at a late age of about 50 years and have a slow course. Congenital pathology is rare.
The causes and etiology of stenosis of the mitral orifice
Among the main causes of stenosis of the mitral valve are two:
- In most cases, the provoking factor is previously suffered rheumatism - 80% of cases this disease leads to cardiac pathology.
- In other cases, and this is 20%, the cause is the transferred infection (among them is a heart injury, infective endocarditis and others).
The disease is formed at a young age, and it consists in a violation of the function of the valve, which is located between the ventricle and the atrium. To understand what the essence of the disease is, it is necessary to know that this valve opens into the diastole, and with it the arterial blood of the left atrium is directed to the left ventricle. This mitral valve consists of two valves, and when there is stenosis, these valves thicken, and the hole through which blood flows, narrows.
Because of this, the pressure in the left atrium increases - the blood from the left atrium does not have time to pump out.
Hemodynamics with mitral stenosis
When the pressure in the left atrium increases, accordingly, it increases in the right atrium, and then in the pulmonary arteries, and, finding a global character, in a small circle of blood circulation. Because of the high pressure, myocardium of the left atrium hypertrophies. The atrium due to this works in a strengthened mode, and the process is transferred to the right atrium. Further, the pressure rises in the lungs and in the pulmonary arteries.
Symptoms of mitral stenosis
Symptoms with stenosis of the mitral valve first manifest themselves in the form of shortness of breath due to the involvement of the lungs in this process, then there are:
- attacks of cardiac asthma due to disruption of gas exchange;
- cough, which can be with mucus or phlegm;
- increased fatigue, palpitations;
- "Heart hump" - bulging in the heart area on the chest - occurs due to hypertrophy of the right ventricle.
Diagnosis of mitral stenosis
Mitral stenosis is detected using the following methods:
- X-ray examination - is carried out to clarify the increase in the chambers of the heart and determine the state of the vessels.
- Electrocardiogram - helps to detect hypertrophy of the right ventricle and left atrium, as well as determine the nature of heart rhythms.
- A phonocardiogram is necessary for determining the amplitude of tone oscillations.
- Echocardiogram - determines the movement of mitral valve flaps, the rate of closure of the mitral valve and the size of the cavity of the left atrium.
Treatment of mitral stenosis
Treatment of stenosis of the mitral valve is non-specific, and is aimed at the general maintenance of the heart and its metabolism, as well as the normalization of blood circulation.
For example, if there is a lack of circulation, ACE inhibitors, cardiac glycosides, diuretics, medicines that improve the water-salt balance are used.
If there are rheumatic processes, then they stop using antirheumatic drugs.
When therapy does not bring the desired results, and there is a threat to life, then surgery is shown - mitral commissurotomy.