Mitral valve prolapse: the main symptoms of mitral valve prolapse, diagnosis and treatment of MVP of the heart

Mitral valve prolapse is a kind of pathology, which consists in the fact that the valve leaflet the heart can sag into the cavity of the left atrium, which does not occur during normal heart function must.

The mitral valve is one of the components of the heart. It serves to ensure that the blood flow that has passed through the valve does not flow back. Valve mobility is provided by tendon chords.

According to the localization of MVP, prolapse of the anterior leaflet, prolapse of the posterior leaflet, and prolapse of both leaflets are distinguished. The most commonly diagnosed prolapse of the anterior leaflet.

The frequency of detection of MVP in the adult population is on average 5-10%. More often this phenomenon is diagnosed in women. (65-75% cases) aged 35-40 years old.

The frequency of detection of MVP in children varies from 2 to 16%. With increasing age, the frequency of detection of MVP also increases. Most often, this ailment is diagnosed in children aged seven to fifteen years.

The pathogenesis of mitral valve prolapse is not fully recognized. The likelihood of the statement that MVP is genetically determined is quite high, since this phenomenon is often accompanies various syndromes, osteogenesis imperfecta, female hypomastia, as well as malformations chest.

At the morphological level, a special (mucosal) layer grows on the valve leaflet. This process destroys the fibrous layer, which leads to the development of MVP.

MVP also results from lengthening of the chords or a weak chordal apparatus, but such cases are much more rare.

With secondary prolapse of the mitral valve at the histological level, no changes occur.

Currently, there is no unequivocal opinion among doctors about the danger of MVP for human life and health. The degree of health risk and diagnostic significance have not yet been assessed.

People with MVP are more likely to get colds. Quite often, people notice violations in the thermoregulation of the body, interruptions in the work of the heart.

Mitral valve prolapse in some cases develops with damage to adjacent structures and elements of the heart (for example, tendinous chords can stretch and rupture, the mitral ring expands, the aortic and tricuspid are affected valves). In such cases, we can talk about the danger of MVP for human health.

As a rule, MVP proceeds favorably in 96-98% cases.

The diagnosis of MVP often raises questions about the suitability of a man for military service. With MVP I-II degree without manifestation of regurgitation (or with regurgitation of I degree), a man for the army will be considered fit.

With regurgitation above grade I, attention is paid to the presence of other diseases (not related to the heart). In such cases, the commission can decide the following: either declare the conscript partially fit for service, or unfit for the army.

Symptoms of mitral valve prolapse and main degrees of cardiac prolapse

Symptoms of mitral valve prolapse can vary depending on the degree of manifestation of pathologies in the structure of the heart. The degree of prolapse is also called mitral regurgitation (that is, the reverse flow of blood from one chamber of the heart to another).

In Russia, three degrees of heart prolapse are distinguished, depending on the degree of prolapse (that is, the protrusion of the organ through the natural openings) below the valve ring:

• grade I - up to 5 mm;
• degree II - 6-10 mm;
• grade III - over 10 mm.

Cardiac prolapse up to 10 mm deep is considered prognostically favorable.

Separately, it should be said about the relationship between MVP and sports. So, with prolapse of the first degree, there are no restrictions on physical activity. With mitral regurgitation of the second degree, auto racing, equestrian sports, diving, gymnastics, wrestling, table tennis, football, figure skating, rugby are allowed. With MVP of the third degree, all sports are contraindicated until the existing defect is corrected.

With an existing prolapse of the heart, dysplastic signs may appear from an early age. the development of certain structures: for example, the appearance of a hernia (inguinal, umbilical), hip dysplasia joints.

People with MVP are much more likely to get colds, suffer from tonsillitis and chronic tonsillitis.

Typical clinical symptoms of mitral valve prolapse include:

• vegetative manifestations (that is, signs of vegetative-vascular dystonia): a feeling of general weakness, reduced performance, low exercise tolerance, short-term fainting, feeling of lack of oxygen, dyspnea);
• cardialgia syndrome: complaints of pain in the region of the heart, which may be stabbing, aching or constricting;
• periodic interruptions in the work of the heart (the person notices how the heartbeat can increase significantly for a short period of time);
• manifestation of hyperventilation syndrome: a person's breathing intensifies, there is a feeling of anxiety for no apparent reason. There is a feeling of lack of air, a lump appears in the throat. The person cannot take a deep breath. It may seem to a person that he is going to die now. Such vegetative crises appear regardless of the degree of physical exertion or the level of stress;
• there may be syncopein which a person loses consciousness for a short time;
• problems with thermoregulation of the body;
• depressive states (erased depression or sub-depression) and experiences of the hypochondriacal type.

The symptoms listed above are more common in females.

With MVP, non-intense pain can occur, and, as a rule, with strong emotional experiences. Accompanied by feelings of anxiety and palpitations: patients often report that they are having panic attacks.

Cardialgias can occur with frequency 32-98%. It is impossible to predict the onset of cardialgias: they can appear both against the background of severe fatigue and stress, and spontaneously. The development of cardialgia in people with heart prolapse is associated (according to a number of scientists) with dysfunction of the autonomic nervous system.

Arrhythmias with MVP are diagnosed in 16-80% cases. Typically, the patient complains of a rapid heartbeat, "jumping" or "fading". In such cases, tachycardia may be due to one reason or another (excitement, stress, coffee intake).

Most people with cardiac prolapse are asymptomatic.

MVP of the heart: how to detect heart valve prolapse

As a rule, the MVP of the heart is found for the following reasons:

• as a result of a planned examination of a person who has no subjective complaints about the state of the cardiovascular system;
• as a result of the detection of signs indicating the presence of mitral regurgitation;
• in studies related to the patient's subjective complaints about problems with syncope, rhythm disturbances and cardialgia;
• identification of MVP in the diagnosis of other cardiovascular diseases.

The following methods are used to diagnose heart valve prolapse:

• Echocardiography: a method for diagnosing the condition of the heart, which is carried out through ultrasound examination (ultrasound). The analysis of the state of the heart and its valve apparatus is carried out. Currently Ultrasound of the heart is considered the only diagnostic method that allows you to reliably identify MVP.
• Electrocardiography: this method allows you to detect changes in the structure of the ventricular complex of the heart, as well as to fix irregularities in the heart rhythm.
• PCG: allows you to identify the sound phenomena of MVP during auscultation. PCG can be especially useful when analyzing the phase indicators of systole.
• Heart X-ray: X-rays are used to identify abnormalities in the size and shape of the heart.

The presence of a prolapse of the heart valve should not scare a woman who wants to become a mother: pregnancy with MVP is not contraindicated.

However, with mitral valve prolapse with grade II regurgitation, pregnancy can occur with some complications. In fact, this diagnosis is a heart defect.

It is necessary to undergo an ultrasound of the heart and consult with the attending cardiologist. But even with such a diagnosis as mitral valve prolapse, it is possible to endure and give birth to a healthy baby, although it is quite possible to use a cesarean section.

With heart disease (mitral insufficiency), complications are possible during pregnancy at the end of the second trimester and during childbirth. Circulatory failure can gradually increase, leading to acute heart failure (manifested through cardiac asthma or pulmonary edema).

There may be a threat of termination of pregnancy due to stagnation of blood in the uterine vessels.

With minor regurgitation, it is almost impossible to detect mitral valve prolapse: it usually takes several years for the formation of clear clinical signs of MVP.

As cardiovascular abnormalities are increasingly common in young couples, careful planning is required before pregnancy occurs.

In children

With MVP of the heart, children most often complain of pain in the chest, severe shortness of breath and occasional dizziness. Fainting may occur. Headaches appear if the child stands up abruptly or has not eaten for a long time. Children with MVP are often irritated and sleep poorly.

When examining a child with MVP, dysplastic constitutional features are often observed, to which include a flat chest, tall stature, underdeveloped muscles, flat feet, myopia and other.

Children with mitral valve prolapse usually suffer from mood swings, anxiety, excitability, and tearfulness. Such children are characterized by various phobias, the development of a strong fear of death. There is a tendency to depressive reactions.

As a rule, during the diagnosis of MVP, complaints and changes in the ECG are absent, therefore the child is considered healthy. In the presence of certain complaints of the child, the identification of mitral valve prolapse signals the presence of vegetative dystonia syndrome.

Anterior mitral valve prolapse: primary and secondary MV prolapse

According to ICD-10, mitral valve prolapse is divided into two main types - primary and secondary. Let's consider them in more detail.

Primary mitral valve prolapse. Primary (or idiopathic) prolapse of the anterior valve leaflet occurs as an independent disease. MVP can be in a person from birth (that is, it is determined at the genetic level). The structure of the heart fibers is significantly disrupted, as a result of which the anterior leaflet thickens and sags. MVP can reach neighboring structures of the heart, which can disrupt their performance. Blood clots can form in the prolapse zone.

Secondary mitral valve prolapse

Secondary MVP is the result of other diseases that provoked MVP. The list of such ailments is quite wide. Against the background of the disease, motor functions in the walls of the left ventricle are enhanced. Tachycardia develops, which provokes a decrease in the filling of the left ventricle with blood. During systole, the walls of the left ventricle and valve walls gradually come closer together, which weakens the tension of the chords - all this provokes the development of heart prolapse.

As mentioned earlier, MV prolapse rarely leads to complications. IN 2-4% cases of mitral valve prolapse can lead to the following complications:

• mitral insufficiency;
• endocarditis bacterial type;
• thromboembolism;
• arrhythmias dangerous to human health;
• sudden death.

The heart valve does not close, what to do, treatment for sagging mitral valve

Treatment for primary prolapse of MK is prescribed depending on the degree of regurgitation. It is necessary to normalize the working and rest conditions, strictly follow the daily routine formed by the doctor, observe the sleep schedule and the correct diet.

The issue of physical exercise for each patient is decided individually according to the doctor's prescription. Most people with MVP, when the heart valve does not close, can handle exercise. Relaxed sports are best.

Mandatory is drug therapy, which includes:

• the fight against vegetative dystonia;
• prevention of the development of myocardial neurodystrophy;
• complex of psychotherapy;
• prevention of the possible appearance of infectious endocarditis.

Recent studies show that the use of drugs that contain magnesium shows high efficiency in MVP therapy. If changes in the repolarization processes are detected on the ECG, medications are prescribed that help to improve metabolism in the myocardium (these include Panangin, Carnitine and Riboxin).

In addition to the main treatment, herbal medicine with sedative properties can be prescribed (taking tinctures from valerian, motherwort or herbal collection).

In exceptional cases, they resort to surgical intervention. With a slight MVP, treatment is not required.

With secondary MVP, it is necessary to promptly treat chronic infections and fight hypercholesterolemia. To do this, you will need to take antibiotics prescribed by your doctor (no self-medication!), As well as adjust your habits and carefully monitor your personal hygiene.

It is necessary to limit the intake of sodium salts, which can be replaced with potassium and magnesium salts (they are found in large quantities in buckwheat and oatmeal, beans, apricots, rose hips, dried apricots and zucchini). Of the drugs, you can drink a course of Panangin for prevention.

As folk methods of treatment, decoctions and tinctures of herbs with a pronounced sedative effect are prescribed.

It is necessary to undergo regular medical examinations. Sagging of the mitral valve can progress with age (with secondary MVP), therefore, it is necessary to observe a doctor for changes in heart processes. Examination by a cardiologist and the necessary control studies should be repeated twice a year.