Mitral regurgitation 1 and 2 of the degree: what is it?
Mitral regurgitation is one of the diagnoses in cardiology, which means that the heart valve failures occurred. Some patients with a slight degree of this disease may live, and not knowing about it. A learn about mitral regurgitation with the passage of medical examinations, when a doctor hears abnormal heart murmur, and sends the patient for further examination. And many patients mitral regurgitation can cause a lot of unpleasant symptoms, sometimes even life threatening. That is why it is important to know the first signs of this disease to prevent the progression of the disease to critical steps and complications.
Regurgitation of the mitral valve. What is it?
Mitral regurgitation, mitral valve insufficiency, mitral valve regurgitation or mitral insufficiency is the equivalent concepts. The term regurgitation is used not only in cardiology but also in other branches of medicine. Literally it means «reverse flooding», that is, when the regurgitation of the fluid begins to move against the natural current.
To understand the mechanisms of the origin of the reverse current of blood in heart cavities, it is necessary to recall the anatomy of the heart and the importance in this of the valves. The human heart is a hollow organ that consists of four interconnected cavities (chambers). These cavities are reduced alternately. In systole the ventricles (during muscle contraction) the release of blood in the vessels of the great circle (the aorta) and small circle (the pulmonary artery) circulation. In their diastole (during relaxation), the filling of the cavities of the ventricles the new amount of blood flowing from the Atria. In the heart very important to keep blood moving in one direction. This ensures an optimal load on the heart muscle and adequate functions.
Valves are flaps that prevent the return of blood from the ventricles into the Atria during systole. Each valve consists of connective tissue (tendon) of the valves. They are attached to the myocardium and papillary muscles. The mitral valve is located in the left parts of the heart, is the bicuspid valve. In diastole, the papillary muscles are relaxed, open and fold against the inner surface of the left ventricle. During the systole of the ventricle, the papillary muscles contract simultaneously with the myocardium, pulling threads of tendon flaps. They tightly interlock with each other, preventing the return of blood in the Atria.
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Why can mitral regurgitation occur?
- Acute trauma to the heart, which leads to a separation of peripapillary muscles or cusps of the mitral valve.
- Infection (e.g., infectious myocarditis, rheumatic fever). The inflammatory process weakens the heart muscle and disrupts the normal operation of the valves. In addition, the infection can affect the tissue of the valves themselves, which reduces their elasticity.
- Acute dilatation (enlargement) of the left ventricle due to ischemia (oxygen starvation) or myocarditis (inflammation of heart muscle). The walls of the ventricles when the extension is pulled and a valve apparatus, the opening between the atrium and the ventricle expands, not allowing the valves to close.
- Mitral valve prolapse – bowing the valve leaflets into the atrium, refers to congenital anomalies of the heart.
- Autoimmune diseases (SLE, rheumatoid arthritis, scleroderma, amyloidosis).
- Atherosclerosis the deposition of cholesterol plaques on the panels of the valves.
- Ischemic heart disease (e.g. myocardial infarction, when affected papillary muscle or chord valves).
The degree of mitral regurgitation
Mitral regurgitation of 1 degree (minimum) is the initial degree of divergence of the folds. Their deflection to the left atrium is not more than 3 – 6 mm. This degree is usually clinically apparent. When listening to the heart (auscultation), the doctor may hear a characteristic murmur at the apex or «snap» of the mitral valve, characteristic of the prolapse. Confirm the regurgitation is only possible with echocardiography (ultrasound).
Mitral regurgitation of 2 degrees is a return of blood in the amount of 1/4 or more of the total amount of blood the left ventricle. Prolapse of the valve may be 6 to 9 mm. At this point the load on the left ventricle becomes greater as the volume of blood that must be pumped increases. In addition, increased pressure in the pulmonary veins and around the pulmonary circulation. All this is manifested by complaints of shortness of breath, weakness and fatigue, disturbances of cardiac rhythm, and sometimes pain in the heart. The patient may experience lightheadedness and fainting. If untreated, may develop heart failure.
Mitral regurgitation grade 3 is the return of blood from the ventricle into the atrium in the amount of more than 1/2 of the volume of the ventricle. Prolapse may be more than 9 mm of deflection of the valve. It is a heavy degree, which not only overloads the left departments of heart, but right. Followed by pulmonary insufficiency with severe dyspnea, cyanosis of the skin, coughing and wheezing during breathing. Heart failure manifests itself in the form of edema, portal hypertension (elevated pressure in the blood vessels of the liver), cardiac rhythm violation.
4 the degree of mitral regurgitation is a very serious condition that is accompanied by heart failure and occurs when the return blood the left ventricle in the amount of more than 2/3.
Depending on the degree of regurgitation and the causes that led to it, is assigned treatment. It may be that both medical and surgical.
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