The prolapse of the mitral valve is a pathology, which in the overwhelming majority of cases is detected at random during the passage of the ultrasound of the heart. According to statistics, about 6% of the population have such an anomaly, while the incidence of women is slightly higher. The prolapse is often diagnosed in childhood and young age.
What is the prolapse of the mitral valve of the heart?
The heart - a kind of pump, a tight muscular organ, designed to provide blood vessels of the whole body. Pumping and circulation of blood occur by maintaining a certain pressure in the heart cavities (chambers). Cavities (there are four of them - two atria and two ventricles) are separated from each other by movable flaps - valves, which, in addition, regulate the level of pressure and set the necessary direction to the blood flow.
The mitral valve formed by the connective tissue is one of the four interstitial dampers, which delimits the left atrium and left ventricle. This valve is bicuspid, and its valves are attached to the wall of the left ventricle by thin tendon threads - chords that depart from papillary muscles. All these anatomical structures work together, with chords and papillary muscles acting as "springs" for the "doors" of the valves.
With the normal functioning of such a device during the contraction of the cardiac muscle, the anterior (aortic) and posterior (ventricular) valves close closely. Thanks to this, blood from the left ventricle under pressure enters the aorta, from where, enriched with oxygen, is carried throughout the body. At the time of relaxation of the heart, when the cavity is dilated and filled with blood, the mitral valve opens, and its valves are directed into the cavity of the left ventricle.
The prolapse of the heart valve is a state of inadequate operation of the valvular apparatus, characterized by loose closure of the mitral valves during the contraction period, which causes a certain volume of blood to leak back from the ventricle to the atrium. Such an abnormal return of blood is called regurgitation . When the valve is closed in this case, one or both of the leaflets prolapse, i. E. They protrude into the left atrium chamber, which does not allow them to normally close.
Is the prolapse of the mitral valve a valvular disease?
Learning about this diagnosis, many patients are interested in: prolapse is a heart defect or not? In fact, this pathology can be attributed to vices, i.e. defects in the development of the structure of the body, which can adversely affect the functioning of the heart. In this case, the considered deviation is often so insignificant that it does not affect cardiac work at all. Most experts agree that uncomplicated prolapse of the mitral septum does not pose any threat, but the development of complications on its background is possible.
Often mitral valve prolapse is a congenital condition, which is associated with a disruption in the structure of connective tissue fibers, as a result of which the valves are highly stretchable, and the chords lengthen. This is due to genetic factors. There are also secondary forms of pathology that result from other diseases and traumatic factors that provoke inflammation or chord break:
- rheumatism ;
- trauma of the chest;
- ischemic heart disease ;
- myocardial infarction, etc.
Prolapse - how dangerous?
Prolapse of the heart can carry danger if there is a significant return of blood (regurgitation) to the atrium, because of which acute or chronic develops pulmonary venous hypertension, there is a violation of the heart rhythm, blood flow to the brain, etc., is severed. The main complications of mitral valve prolapse are:
- insufficiency of the mitral valve;
- infective endocarditis;
- perforation of the valve leaf;
- arrhythmias, conduction disorders;
- stroke.
Mitral valve prolapse - degree
To assess the severity of cardiac dysfunction, it is customary to classify the pathology into several degrees, based on the depth of the deflection of the valves into the left atrial chamber and the volume of the reverse blood flow. In this case, the prolapse of the mitral valve can be accompanied by a swelling in the atrial cavity of the anterior, posterior, or two valves. Measurement is possible only through instrumental-visualization methods of diagnosis.
Mitral valve prolapse of the 1st degree
In this case, the deflection of the leaflets is 3-6 mm. A prolapse of the 1 st degree is an easy deviation, and with such a minimum deflection, a sizable failure of the functioning of the cardiovascular system is seldom observed. Clinical manifestations are often completely absent. If mitral valve prolapse of grade 1 with regurgitation is observed, some swirl of blood is fixed, which does not affect blood circulation.
Mitral valve prolapse 2 degrees
The diagnosed prolapse of the 2nd degree is characterized by the deflection of the "door" of the valve, reaching 9 mm. With such a deviation, one can speak of a circulatory disorder that gives a non-intensive symptomatology, but is accompanied by a risk of complications. The prolapse of the mitral valve with regurgitation in this case causes a reverse blood current, capable of reaching half of the atrium.
Mitral valve prolapse 3 degrees
A severe variant is a prolapse of grade 3, accompanied by a divergence of valve flaps sagging by 9 mm or more. Serious changes in the structure of the heart, in which the atrial cavity is dilated, the walls of the ventricle are thickened. The back stream of blood is so intense that it takes out the posterior walls of the atrial cavity. The clinical picture is clearly pronounced, complications progress without treatment.
Valve prolapse - symptoms
As experts note, with genetically determined mitral valve deflection, patients have such appearance features as high stature, leanness, long arms and legs, thin skin. Often there is excessive mobility of joints, visual impairment. With a mild degree of defect, in most cases, patients do not have any complaints. When regurgitation reaches a significant volume, the prolapse symptoms can cause the following:
- general weakness;
- dizziness;
- headache;
- dyspnea;
- sweating;
- discomfort in the heart;
- nausea;
- tremor;
- increased heart rate;
- palpitation;
- a sense of lack of oxygen;
- a slight increase in body temperature.
Does the heart hurt with mitral valve prolapse?
Pain in the heart with mitral valve prolapse is not an obligatory, but often observed symptom, especially at 2 and 3 degrees of damage and in cases of secondary prolapse of valve flaps. Often the pain is noted after emotional stress, stress, fright, physical exertion, but it is not excluded in a state of rest. The nature of discomfort is different: tingling, aching, pressing, etc. If the prolapse of the valve is associated with a frequent sensation of pain, this indicates a serious disorder and possible complications.
Mitral valve prolapse - diagnosis
During medical examination during auscultation (listening to the heart with a stethophonendoscope), the specialist is able to detect certain noise caused by the opening and closing of the valves. This may be the reason for the appointment of a more detailed further examination, and in such cases it is advisable to conduct ultrasound (echocardiography). By means of ultrasound of the heart, mitral valve prolapse is detected reliably, and this method accurately estimates the degree of pathology. In addition, such research methods can be assigned:
- electrocardiogram;
- Holter monitoring of ECG.
Mitral valve prolapse - treatment
A large number of people who have prolapse, treatment is not required. If there are no clinical manifestations, the patient does not bother, the examination does not reveal cardiac dysfunction, only observation with periodic diagnostics and a healthy lifestyle are recommended. The question of possible physical exertion is discussed in each case individually.
The prolapse of the mitral valve, characterized by severe symptomatology and various cardiac dysfunctions, is subject to therapy. Drug treatment is long, may include the following groups of drugs:
- beta-blockers;
- vitamins of group B, PP;
- preparations of magnesium;
- sedatives;
- tranquilizers.
In addition to the pharmacological component, complex therapy often includes other methods: breathing exercises, physiotherapy, physiotherapy, massage, psychotherapy. Patients are recommended to sanatorium treatment. In case of serious abnormalities, a high degree of regurgitation is resorted to in operative ways. This can be a restorative operation on the mitral valve (for example, suturing the valves, shortening the chord), or a radical method - valve prosthetics.