Mitral regurgitation

Cause pathogenesis main pathological changes of the valve, papillary muscles and tendons of adhesion shortened, so that the valve closure of the normal systolic left ventricular inflow of blood back to the left atrium, left atrial dilatation and hypertrophy. telangiectasia lung, pulmonary venous congestion, the diastolic left ventricular filling an increase in the volume of lung congestion mitigation, Therefore mitral regurgitation early, lung congestion is intermittent, patients can more long-term asymptomatic. If there is the left ventricular failure, left ventricular end-diastolic hypertension, pulmonary congestion increase, followed, also increased pulmonary artery pressure, there right ventricular hypertrophy and right ventricular failure. Performance of a clinical symptoms asymptomatic longer, in the event of the left ventricular failure, weak, easily tired, palpitations and breathing difficulties, the condition for the rapid deterioration. Can be combined with atrial fibrillation. Pulmonary edema and hemoptysis more rare for mitral stenosis. 2, signs apexcardiogram left shift, the apex can touch favors sexual desire, heart voiced sector under the left shift. Apical a three and above all systolic murmur, and the back of the left under the conduction, can be accompanied by systolic small tremor, apical first heart sounds normal or weakened, a few cases have the third heart sound and short diastolic murmur. Because of this cacophony of left atrial diastolic blood flow through the mitral rapid access have left ventricle. Second pulmonary valve sound hyperthyroidism and secession. Laboratory and one other inspection, X-ray left atrium and left ventricle increased beyond a pulmonary trunk abdomen, increased pulmonary vascular video, right anterior oblique esophagus can be seen by the left atrium increasing shift to right back. 2, ECG left ventricular hypertrophy, left side axis, and P-wave bimodal widened. 3, echocardiography ① M : continued to show a double peak, but the rapid decline in EF, left atrial diameter increases. ② two Tsim ultrasound : valves and tendons thickened, echogenic, systolic leaves around not completely closed. Left atrial increased left ventricular diameter. ③ Doppler ultrasound : the mitral valve can be measured systolic turbulence spectrum. Typical diagnosis is not difficult diagnosis, and the attention to other non-rheumatic mitral regurgitation differential. An acute mitral regurgitation due to infectious endocarditis valve rupture, perforation, Acute myocardial infarction to the papillary muscle dysfunction, or causes such as trauma. Clinical more sudden onset, the apex emerging systolic murmur, severe acute left ventricular failure. 2, mitral valve prolapse syndrome often as leaf tissue after mitral mucinous change, make mitral systolic broke into the left atrium, and the formation of the mitral regurgitation corresponding murmur, and systolic and Kara Music. The disease can be accompanied by abnormal chest, straight back, spine and other abnormal lateral process. 3, papillary muscle dysfunction due to papillary muscle in chronic ischemia, fibrosis or attachment sites change expansion of left ventricular papillary muscle contraction offset location, may lead to contraction of papillary muscle weakness and dysfunction. The clinical characteristics of apical systolic murmur as a whole; Noise is not constant, with the posture, breathing changes, can be accompanied by diastolic Benma law fourth heart sounds, can cause chronic coronary insufficiency, cardiac disease, Myocardial amyloid changes, carcinoid tumors, congenital papillary muscles, tendons, and other deformities. Complication of infective endocarditis, more prone to, the mild mitral regurgitation cases, the more common atrial fibrillation. patients often associated with mitral stenosis, systemic embolism occurred than mitral stenosis rare. A treatment, the right medical treatment, mild cases of mitral regurgitation, the main attention to the prevention of recurrence of rheumatoid activities, surgery and instruments before and after operation in a timely manner with antibiotics to prevent infection endocarditis. With atrial fibrillation and heart failure, the application of digitalis and vasodilator. 2, surgical treatment (1) mitral valve replacement and mitral regurgitation narrow, with mitral regurgitation or mainly although mainly in the narrow, funnel-disease, heart function III-IV class, or acute mitral regurgitation, the symptoms deterioration and the emergence of acute left heart failure, can be considered OK valve replacement surgery. (2) mitral annulus angioplasty because if the expansion valve or valve disease light activity, and mainly to the closure of incomplete cases, may be considered mitral annulus angioplasty. Surgical treatment for attention with mitral stenosis chapters.