Scientific editor: Strokina OA, therapist, doctor of functional diagnostics. Practical experience since 2015.
Mitral valve prolapse - sag (deflection) of one or both of the mitral valve into the left atrium during contraction of the left ventricle.
Manifestations of mitral valve prolapse may be found both in children and in adults, as an accident, and in the course of the impact survey. The phenomenon of prolapse is described relatively recently - only in the second half of the 60-ies of the last century, when there was a method of ultrasound examination of the heart.
Mitral valve prolapse occurs in 5 to 10% of people, mostly women.
Isolated primary and secondary mitral valve prolapse. The first option is the vast majority of cases of diagnosed pathology. It is a congenital abnormality and is often associated with other congenital defects of connective tissue:
- Marfan syndrome;
- specific embodiments syndrome, Ehlers-Danlos,
- elastic pseudoxanthoma,
- osteogenesis imperfecta;
- one embodiment of polycystic kidney disease in adults.
Secondary prolapse occurs as a complication of the underlying disease, such as:
- circulatory disorders of the papillary muscles (they hold the leaflets in proper position and prevent sag toward the atrium);
- hypertrophic cardiomyopathy;
Manifestations of mitral valve prolapse
In most cases the disease is hidden and reveal accident during preventive examination.
In other cases, the symptoms of mitral valve prolapse may include neuro symptoms (vascular) dystonia, especially in young patients. These symptoms include:
- the feeling of lack of air (there is a desire to take a deep, full breath);
- a sense of "chilling";
- frequent or, on the contrary, infrequent urination in response to psycho-emotional stress;
- morning and night headache, Dizziness, mood instability;
- syncopal presyncopal and conditions that may be a manifestation of autonomic crisis.
In addition to the symptoms of NDCs mitral valve prolapse may be accompanied by:
- palpitations or cardiac arrhythmias, from extrasystoles (extraordinary contraction of the heart) embodiments in mild mitral valve prolapse to atrial fibrillation in severe forms pathology;
- pain in the left side of chest (stabbing, aching, without regard to physical or emotional stress).
Diagnosis always starts with a dialogue with the cardiologist. He listens carefully to the patient's complaint, to ask additional questions, examines the history of the disease.
During the inspection the expert can detect the likely cause of the symptoms due to circumstantial evidence. Prolapse himself he suspected the first time in cardiac auscultation. During ventricular appears the so-called "click", sometimes followed by the noise equivalent backflow of blood into the atrium. However, such signs may not be audible under mild prolapse.
Laboratory methods for diagnosis of mitral valve prolapse does not exist. Among the tools are of great importance:
- ECG - in patients with mitral valve prolapse do not show specific changes. Sometimes the film reveal heart rhythm disturbances in the form of premature beats, blockades pathways, atrial fibrillation).
- transthoracic cardiac ultrasound (echocardiography, carried out through the chest) - the single most accessible and easiest method survey, which allows to determine precisely mitral valve prolapse, the extent and characteristics of its failure function.
When hidden within prolapse without evidence of mitral valve insufficiency or without evidence of arrhythmias in the EKG no need for treatment. But the patient must be monitored for the emergence of risk factors for complications.
- Recommended ultrasound inspection every 1-2 years;
- Recommended rejection of the use of strong tea, coffee, alcohol and smoking;
- Recommended intake of magnesium preparations. The researchers found a decrease of magnesium levels in the body of patients with mitral valve prolapse.
Most drug regimens prolapse do not have evidence in the form of clinical trials. Most of them are based on symptomatic treatment.
Increasingly, for the treatment of prolapse with severe mitral regurgitation (backflow of blood into the atrium) using a surgical technique - plastic valve or a prosthesis.
Mitral valve prolapse is usually a benign. Complications are more common in patients with systolic murmur, thickened, elongated mitral leaflet or an increase in the cavity of the left ventricle or the left atrium.
Complications of mitral valve prolapse include:
- Detachment of the tendon strands
- Expressed mitral valve insufficiency,
- Fibrin deposition on the cusp of the mitral valve,
- Cardiac arrhythmias,
- Cerebrovascular disease (ischemic stroke),
- Infectious endocarditis,
- Sudden cardiac death (only in severe mitral regurgitation).
- Movshovich BL DMN, prof., Fox DN Management of patients with mitral valve prolapse in the clinic. - Medical Research and Practice portal attending physician, 2001.
- "Heart disease: a guide for physicians' / Ed R. G. Oganov, IA G. Fomina. - M: Litterra 2006.