Heart disease

Heart disease is a kind of structural anomalies and deformations of valves, septa, openings between cardiac chambers and vessels that disrupt blood circulation through internal cardiac vessels and predispose to the formation of an acute and chronic form of inadequate circulatory function. Heart disease by etiological factors is of an innate origin and acquired.

Heart defects with a congenital etiology are divided into defects, which are an anomaly of the embryonic formation of S.S.S.And on heart defects, developing as a consequence of endocardial pathologies during the intrauterine development. Given morphological lesions, this category of heart disease happens with anomalies in the location of the heart, in the pathological structure of the septa, both between the ventricles and between the atria.

There is also a defect in the arterial duct, the valvular apparatus of the heart, the aorta and the movement of significant vessels. For heart disease with acquired etiology, development in the background of rheumatic heart disease, atherosclerosis, and sometimes after the transferred injuries and syphilis is inherent.

Heart disease causes

Genetic mutations, various infectious processes, endogenous, as well as exogenous intoxication during pregnancy can influence the formation of heart disease of congenital etiology. In addition, for this category of heart defects are characterized by various violations in the chromosome set.

Of the characteristic changes, trisomy 21 is noted in Down's syndrome. Practically 50% of patients with such genetic pathology are born with CHD( congenital heart disease), namely, ventricular septal defects or atrioventricular defects. Sometimes mutations occur immediately in several genes, while contributing to the development of heart disease. Such mutations as in TBX 5 are found in many patients diagnosed with Holt-Oram syndrome, which refers to an autosomal type disease having septal defects. The cause of the development of the supra-valued aortic stenosis are mutations occurring in the elastin gene, but changes in NKX lead to the development of the heart defect of the tetralogy of Fallot.

In addition, heart disease can occur as a result of various pathological processes occurring in the body. For example, in 85% of cases on the development of mitral stenosis and in 26% for the damage of the aortic valve affects rheumatism. It can also contribute to the formation of various combinations of inadequate operation of certain valves and stenosis. By the formation of heart disease, acquired over a lifetime, can cause sepsis, endocarditis infectious nature, injury, atherosclerosis, and in some cases - Libman-Sacks endocarditis, rheumatoid arthritis, causing visceral lesions and scleroderma.

Sometimes, various degenerative changes cause the development of isolated mitral and aortic insufficiency, aortic stenosis, for which non-rheumatic origin is characteristic.

Heart disease symptoms

Any organic lesions of the heart valves or its structures, which become the cause of characteristic disorders, are found in the general group called "heart disease".

The characteristic features of these anomalies are the main indicators by which it is possible to diagnose a certain heart disease, and also at what stage of development it is. At the same time, there is a symptomatology with a congenital etiology, which is determined almost immediately from the moment of birth, but for the acquired heart anomalies there is a scanty clinic, especially in the compensatory stage of the disease.

As a rule, the clinical symptomatology of heart disease can be conditionally divided into general signs of the disease and specific ones. For some disorders in the structure of the heart or blood vessels there is a certain specificity of symptoms, but the common signs are typical for many diseases of the whole circulatory system. Therefore, heart disease, for example, in infants has a more nonspecific symptomatology, in contrast to the symptoms of a certain type of disturbance in the blood flow system.

Children's heart disease is differentiated by the types of coloration of the skin. With cyanotic coloring of the skin, blue defects are considered, and white blemishes are characterized by a pale shade. With heart defects of white color, venous blood does not enter the ventricle located on the left side of the heart or narrowing its outlet, as well as the aorta parallel to the arc. And with blue flaws there is a mixing of blood or a transposition of blood vessels. It is very rare to observe the appearance of rapidly emerging cyanosis of the skin in a child, which makes it possible to assume the existing heart defect is not in the singular. An additional examination is required to confirm this diagnosis.

Symptoms of general manifestations include the appearance of signs in the form of dizziness, frequent heartbeat, increase or decrease in blood pressure, dyspnea, cyanosis of the skin, lung edema, muscle weakness, fainting, etc. All these symptoms can not accurately testify about the existing heart disease, so accurate diagnosis of the disease is possible after a thorough examination. For example, the heart defect of the acquired character can be identified after the audition, especially if the patient has a history of a characteristic for this violation. The mechanism of hemodynamic disorders makes it possible to immediately determine the type of heart defect reliably and quickly, but the stage of development is much more difficult to identify. This can be done with the appearance of signs of a disease of a non-specific nature. The greatest number of clinical symptoms is characteristic of heart defects in combination or combined form.

With a subjective assessment of congenital heart diseases, there is an insignificant intensity of symptomatic manifestations, whereas the acquired ones are characterized by severity in such stages as decompensation and subcompensation.

The clinical symptomatology of stenosis is more pronounced than the failure of the valves. Mitral stenosis manifests itself in the form of diastolic cat purring, a lag of the pulse on the left hand artery as a result of compression of the subclavian artery on the left, acrocyanosis, in the form of a heart hump, cyanosis in the nasolabial triangle.

In the subcompensation and decompensation stages, LH develops, leading to difficulty breathing, the appearance of a dry cough with scanty white sputum. These symptoms increase with each time and lead to the progression of the disease, which causes the appearance of an aggravated condition and weakness in the body.

With absolute cardiac decompensation, patients develop edema on some parts of the body and pulmonary edema. For stenotic defect of the first degree, affecting the mitral valve, when performing physical exertion, dyspnea with a feeling of heartbeat and dry cough is characteristic. The deformation of the valves is noted on both the aortic and the tricuspid valve. With aortic lesion, systolic murmur noise is detected, palpation of a weak pulse with the presence of a heart hump between the fourth and fifth ribs. With an anomaly of the tricuspid valve, there are edemas, heaviness in the liver, which is a sign of complete filling of blood vessels. Sometimes veins expand on the lower extremities.

The symptomatology of insufficient functioning of the aortic valve consists of changes in the heart rate and blood pressure. In this case, the pulse is very strained, the pupil sizes change in diastole and systole, and also the pulse of the Quincke of capillary origin is observed. For the period of decompensation, the pressure is on low figures. In addition, this heart disease is characterized by its progression, and changes that occur in the myocardium, very quickly cause heart failure( heart failure).

In patients at a younger age, as well as among children with congenital heart disease or early acquired, the formation of a heart hump is noted as a result of increased pressure of the enlarged and altered myocardium of the left ventricle on the anterior wall of the chest.

With a congenital heart anomaly, frequent cardiac beat and effective circulation are noted, which are characteristic since birth. Very often, with such defects, cyanosis is detected due to a defect in the septum between the atrium or between the ventricle, the transposition of the aorta, stenosis of the right ventricle and its hypertrophy. All these symptomatic signs also have a heart defect, like the tetralogy of Fallot, which is very often developed in newborns.

Heart disease in children

Cardiac pathology, which is characterized by defects in the valve apparatus, as well as in its walls is called heart disease. In the future, it leads to the development of cardiovascular failure.

In children, heart defects are innate etiology or can be acquired during life. Causes in the formation of congenital defects in the form of defects in the heart and adjacent vessels are considered violations in the processes of embryogenesis. These heart defects include: defects between the septa, both between the ventricles and between the atria;Defect in the form of an open ductus arteriosus;Stenosis of the aorta;Tetrad of Fallot;Stenosis of the pulmonary artery of an isolated character;Coarctation of the aorta. All these cardiac pathologies in the form of heart defects are laid in the prenatal period, which can be detected using ultrasound of the heart, and in the early stages of development, using electrocardiography or dopplerometry.

The main reasons for the development of heart disease in children include: a hereditary factor, smoking and drinking during pregnancy, an ecologically unfavorable zone, the presence in a woman's history of miscarriages or stillbirths, and an infectious disease, such as rubella, born during pregnancy.

Acquired cardiac defects are characterized by anomalies in the valves, in the form of stenosis or insufficient heart function. These heart defects in childhood develop as a result of some diseases. These include infectious endocarditis, mitral valve prolapse and rheumatism.

To determine the heart defect in a child, first of all pay attention to the noise during auscultation of the heart. The existing organic noises, indicate a presumptive heart disease. A child with such a diagnosis adds very little to weight every month, about 400 grams, he has shortness of breath, and he quickly becomes tired. As a rule, these symptoms are manifested in the process of feeding. At the same time, heart failure is characterized by tachycardia and cyanosis of the skin.

Basically, there is no single answer in the treatment of pediatric heart disease. Many factors play a role in the choice of therapeutic treatment. This is the nature of the disease, the age of the child and his condition. It is important to take into account also such a moment that heart disease in children can pass independently, after reaching fifteen or sixteen years. All this refers to heart defects with a congenital etiology. Very often, initially they begin to treat a disease that caused the development of heart disease in children or contributed to its progression. In this case, prophylactic and medicinal treatment is used. But the acquired cardiac pathology often ends with a surgical operation. In this case it is a commissurotomy that is performed with isolated mitral stenosis.

Surgical intervention in the presence of mitral insufficiency is prescribed in cases of complications or deterioration of the child's well-being. The operation is performed with the replacement of the valve by an artificial one. To conduct therapeutic therapy for heart disease, a corresponding protein diet with water and salt restriction, various measures of a general hygiene nature, as well as the constant performance of physical therapy classes are prescribed. A child with a heart disease is taught to perform certain physical activities that constantly train the heart muscle. First of all, it is walking, which helps to increase blood circulation and prepares muscles for the following exercises. Then perform a set of exercises that straighten the spine and thorax. Of course, gymnastics for the respiratory system is an integral part of the classes.

Heart disease in newborns

This category is represented by a diverse group of diseases that can manifest as minor anomalies and incompatible with life pathologies of the heart.

In newborns, heart disease can be based on certain genetic causes, and the environment can strongly influence its formation, especially in the first trimester of pregnancy.

In addition, if the expectant mother used some medicines, narcotics, alcohol, smoked or had some diseases of a viral or bacterial aetiology, then there is a huge probability of developing heart disease first in the fetus and then in the newborn. Some types of heart defects develop for reasons of hereditary etiology. All these pathologies can be determined even when examining pregnant women on ultrasound, and sometimes with late diagnosis, but then the heart defects manifest themselves at different ages.

In newborns, heart defects are a common pathology and a very serious problem. They are divided into heart diseases characterized by discharge of blood and without discharge. Clinical symptoms are most pronounced in the first variant of heart disease, when there is a defect between the atrial septa. In this case, the blood without oxygen enrichment enters the circulatory system, such as large, so the newborn appears cyanosis or bluish coloring of the skin. The characteristic cyanosis is visible on the lips, so there is the medical term "blue baby".Cyanosis appears and with a defect of the septum between the ventricles. This is due to the vice, which causes the heart and the small circle to overload due to pressure in different parts of the heart.

For heart defects of congenital origin, but without dropping blood, aorta coarctation is more characteristic. In this case, there is no cyanotic shade on the skin, but with a different level of development of the defect, cyanosis may form.

The most common birth defects include tetralogy of Fallot and coarctation of the aorta. But among the most common vices are defects in the atrial and ventricular septa.

The tetralogy of Fallot is formed in the fourth to sixth weeks of pregnancy as a consequence of violations in the development of the heart. A significant role belongs to heredity, but risk factors play an important role. Most often this disorder occurs in newborns with Down syndrome. The tetralogy of Fallot is characterized by a defect of the septum between the ventricles, the position of the aorta changes, the pulmonary aorta narrows and the right ventricle increases. At the same time, a rustle in the heart is heard, shortness of breath is noted, and lips and fingers turn blue.

Aortic coarctation in newborns is characterized by a narrowing of the aorta itself. Depending on this restriction, there are two types: post-ductal and pre-ductal. The last cardiac type refers to a very serious pathology incompatible with life. In this case, surgical intervention is necessary, since this heart disease leads to blueing of the lower body.

The heart valves of congenital origin are represented as protruding parts of the endocardium, which lining the inner part of the heart. With such vices, the blood circulates only in one direction. The most common heart defects from this category are aortic and pulmonary malformation. The symptomatology of this pathology consists of a certain cardiac rustle, shortness of breath, swelling of the extremities, chest pain, lethargy and loss of consciousness. To clarify the diagnosis, electrocardiography is used, and one of the possible methods of treatment is surgery.

Diagnosis in newborn heart defects is to identify this pathology before birth, that is, the prenatal diagnosis method is used. There is an invasive and non-invasive examination. The first method of diagnosis includes cordocentesis, chorion biopsy and amniocentesis. The second method of examination includes a blood test for a biopsy in the mother, ultrasound is pregnant in the first half of pregnancy, and to clarify the diagnosis - a repeat ultrasound.

A certain group of heart defects in infants in some cases is simply life-threatening, so in this case an emergency surgery is prescribed. For example, with such a heart condition as aortic coarctation, surgically remove the narrowed area. In other cases, surgical intervention is postponed for a certain period of time, if possible without prompt intervention.

Acquired heart defects

This pathology in the structure and functioning of the heart valves, which are formed during a person's life under the influence of certain factors, lead to violations of the heart. The formation of heart defects of acquired nature is influenced by infectious lesions or various inflammatory processes, as well as certain overloads of the heart chambers.

The heart disease that a person has acquired during life, is also called valvular heart disease. It is characterized by stenosis or insufficient functioning of the valve, and at some moments manifested by a combined cardiac malformation. When this diagnosis is made, a mismatch in the mitral valve is detected, which is unable to regulate blood flow and causes stagnation in both circulation circles. And overload of some cardiac parts leads to their hypertrophy, and this, in turn, changes the whole structure of the heart.

Acquired heart diseases are rarely subject to timely diagnosis, which distinguishes them from CHD.Very often people suffer many infectious diseases "on their feet", and this can cause rheumatism or myocarditis. Heart defects with acquired etiology can also be caused by improperly prescribed treatment.

In addition, this category of cardiac pathology is classified by etiological signs for heart defects with syphilitic origin, atherosclerotic, rheumatic, and also as a consequence of bacterial endocarditis.

Acquired heart defects are characterized by a high or moderate degree of hemodynamic disorders in the heart, and there are also such vices that this dynamics is not affected at all. Depending on this hemodynamics several types of defects of the acquired character are isolated, namely compensated, decompensated and subcompensated.

An important point for diagnosing the type of defect is its localization. Such heart defects, as monoclaved, include mitral cardiac defect, aortic and tricuspid. In this case only one valve is deformed. In case of a lesion, both speak of a combined valvular heart disease. This category includes mitral-tricuspid, mitral-aortic, aortic-mitral-tricuspidal defects, etc.

With minor heart defects, the symptomatology of the disease may not manifest itself for a long time. But the hemodynamically significant heart defects of the acquired character are characterized by shortness of breath, cyanosis, edema, rapid heartbeat, pain in this area and coughing. A characteristic clinical sign of any type of blemish is cardiac noise. For more accurate diagnosis, consult a cardiologist who performs the examination using palpation, percussion, auscultation, which makes it possible to listen to a clearer heart rate and the noise present in the heart. In addition, methods of ECHO-cardioscopy and Dopplerography are used. All this will help to assess whether a certain heart defect has an expression, as well as its decompensated degree.

Setting a diagnosis such as heart disease, requires a person more responsibility for their health. First of all, it is necessary to limit the performance of heavy physical exertion, especially this applies to professional sports. It is also important to observe the right lifestyle with a rational diet and daily regimen, regularly to prevent endocarditis, cardiac arrhythmias and circulatory failure, as there are prerequisites for the formation of vices in this category of patients. In addition, timely treatment of infectious diseases with the prevention of rheumatism and endocarditis of bacterial etiology can prevent the development of acquired heart defects.

To date, two methods are used to treat the acquired category of this cardiac pathology. These include the surgical method of treatment and medication. Sometimes this anomaly becomes completely compensated, which allows the patient to forget about his diagnosis in the form of a heart defect of acquired origin. However, for this purpose, timely diagnosis of the disease and properly prescribed treatment remain an important point.

The therapeutic methods of treatment include the arrest of the process of inflammation in the heart, followed by a surgical operation to eliminate heart disease. As a rule, surgical intervention is conducted on the open heart and the effectiveness of the operation largely depends on the early timing of its operation. But such complications of heart defects, as insufficient blood circulation work or broken heart rhythm can be eliminated without performing a surgical operation.

Aortic heart disease

This disease is divided into stenosis and aortic insufficiency. Today, aortic stenosis, among acquired heart defects, is most often detected in North America and Europe. About 7% diagnose aortic stenosis of calcifying nature in people after 65 years and mainly among the male half of the population. Only 11% account for such an etiological factor, as rheumatism in the formation of stenosis of the aortic aorta. In the most developed countries, the cause of the development of this cardiac defect is almost 82% of the degenerative calcification process occurring on the aortic valve.

One-third of patients suffer from a double-leaved aortic valve disease, where valvular fibrosis progresses as a result of damage to the valve tissues themselves and atherogenic processes accelerate, and this is the reason for the formation of aortic defect in the form of stenosis. And such provoking factors as smoking, dyslipidemia, the age of the patient, significantly increased cholesterol level can contribute to the acceleration of fibrotic processes and the formation of aortic malformation in the heart.

Depending on the severity of the disease, several of its degrees are isolated. These include: stenosis of the aorta with a slight constriction, moderate and severe.

The symptomatic pattern of aortic heart disease depends on the anatomical changes in the aortic valve. With minor lesions, most patients live and work in their usual rhythm of life for a long time and do not make certain complaints that would indicate aortic malformation. In some cases, the first symptom of aortic malformation is cardiac insufficiency( CH).Hemodynamic disorders represent increased fatigue, which is associated with the centralization of blood flow. All this becomes the cause of development in patients with dizziness and fainting. Almost 35% of patients have pain characterized by angina pectoris. When decompensating the blemish appears shortness of breath after any physical exertion. But as a result of inadequate physical activity, pulmonary edema may occur. Symptoms such as cardiac asthma and angina pectoris are unfavorable predictions of the disease.

Visually, during examination of the patient, paleness is noted, and with severe stenosis - pulse of small and slow filling, and the pressure of systole and pulse is reduced. The heart beat on the top is audible in the form of a powerful tone, spilled, rising with a shift to the left and down. When applying the palm to the handle of the sternum, a marked shivering of the systole is felt. During percussion there is a border of dullness of the heart with a shift to the left and down almost 20 mm, and sometimes more. Auscultation hears a weakened second tone between the ribs, as well as a systolic noise that is carried to all parts of the heart, to the back and neck vessels. Sometimes noise is remotely auscultated. And with the disappearance of the second tone of the aorta, one can speak with full certainty about pronounced aortic stenosis.

Aortic heart disease is characterized by five stages of percolation.

The first stage is absolute compensation. Patients do not present any typical complaints, the vice is diagnosed during auscultation. With the help of ECHO-cardiography, an insignificant pressure gradient of the systole on the aortic valve( about 40 mm Hg) is determined. Operative treatment is not carried out.

The second stage of the disease is a hidden lack of work of the heart. Here there is fatigue, dyspnea on the background of physical exertion, dizziness. In addition to signs of aortic stenosis in auscultation, a characteristic sign of ventricular hypertrophy on the left is obtained with the help of X-ray and electrocardiographic studies. During ECHO cardiography, it is possible to determine the moderate systolic pressure on the aortic valve( about 70 mm Hg) and here an operation is simply necessary.

The third stage is characterized by relative coronary insufficiency, which is manifested by pain resembling angina pectoris;Shortness of breath progresses;fainting and dizziness on a background of minor physical exertion. The border of the heart is clearly enlarged due to the ventricle on the left. On the electrocardiogram there are all signs of an increase in the ventricle in the left part of the heart and hypoxia of the heart muscle. When ECHO-cardiography - maximally increases the pressure of the systole above 60 mm Hg. Art. In this state, an urgent operation is appointed.

In the fourth stage of aortic heart disease, left ventricular failure is expressed. Complaints of patients are the same as in the third stage of the disease, but pain and other sensations are much stronger. Occasionally, paroxysmal attacks of dyspnea appear at intervals, and mostly at night;Cardiac asthma;The liver is enlarged and there is a swelling of the lungs. On the electrocardiogram, all disorders associated with coronary circulation and atrial fibrillation are seen. And with the ECHO-cardiographic study, calcification of the aortic valve is detected. On the x-ray, an enlarged ventricle in the left part of the heart is determined, as well as stagnation in the lungs. Recommendations of bed rest and appointment of conservative methods of therapy temporarily improve the general condition of some patients. In this case, the surgical method of treatment is basically simply impossible. Everything is decided individually.

And the last stage of aortic heart disease is terminal. It is characterized by progression of RV and LV deficiency. At this stage, all signs of the disease are quite pronounced. The patients are in extremely serious condition, therefore the treatment in this case is no longer effective and surgical operations are also not carried out.

Aortic insufficiency refers to one of the varieties of aortic malformations. The frequency of its detection, as a rule, is directly dependent on the methods of diagnostic studies. The spread of this type of blemish increases with the age of the individual, and all clinical signs of severe failure are more often detected in the male sex.

One of the frequent reasons for the formation of this pathology is the aortic aneurysm of the ascending part, as well as the bicuspid aortic valve. In some cases, the cause of the pathology is almost 50% of the degenerative disorders of the aortic valve. In 15%, etiologic factor is rheumatism and atherosclerosis, and in 8% - endocarditis of infectious origin.

As with aortic stenosis, there are three degrees of severity of aortic heart disease: initial, moderate and severe.

Symptoms of aortic insufficiency consist of the rate of formation and the size of valvular defects. In the compensatory phase there are no subjective signs of the disease. The development of aortic heart disease proceeds smoothly, even with a significant regurgitation of the aorta.

With the rapid formation of extensive defects, the symptoms gain progression, and this causes the inadequate operation of the heart( CH).A certain number of patients get dizzy, and they feel a heartbeat. In addition, almost half of patients diagnosed with aortic insufficiency, whose causes are atherosclerosis or syphilis, the main symptom of the disease is angina pectoris.

Attacks of labored breathing develop at the beginning of the pathological process with increasing physical exertion, and with the formation of left ventricular failure, dyspnea appears at rest and is characterized by symptoms of cardiac asthma. Sometimes everything is complicated by the addition of pulmonary edema. In addition, the patients are very pale, their carotid, humeral and temporal arteries pulsate, the symptoms of Musset, Landolphi, Mueller and Quincke are observed. Upon examination, Corrigan's pulse is observed, a very strong and slightly diffused push at the apex of the heart is heard during auscultation, and its borders are significantly enlarged to the left and down. Above the vessels of a large structure, the Traube tone is of a double character, and when pressed on the iliac artery region, the Durozier noise appears. The systolic pressure rises to 170 mm Hg. And, for diastolic pressure indicators, a decrease of almost 40 mm Hg is characteristic. Art.

This pathology develops with the appearance of the first signs before the death of the patient, on average it takes about seven years. Very quickly, there is insufficient heart function in the process of detachment of the valve or rather severe damage to the valve with endocarditis. Such patients live a little more than a year. A more favorable prognosis is characterized by aortic heart disease in the background of atherosclerotic origin, which rarely leads to significant valve changes.

Mitral heart disease

This category of diseases includes stenosis and insufficient function of the mitral valve. In the first case, stenosis is considered a frequent rheumatic heart disease, the cause of which is a long-flowing rheumatic endocarditis. As a rule, this type of cardiac pathology occurs more among the younger generation and in 80% of cases affects the female half of the population. Very rarely, the mitral orifice narrows as a result of carcinoid syndrome, rheumatoid arthritis and lupus erythematosus. And 13% of cases are caused by changes in valves of a degenerative nature.

Mitral stenosis stenosis is minor, moderate and significant.

All clinical symptoms of mitral heart disease in the form of stenosis have a certain dependence on the stage of this pathology, and in what state is the blood circulation. With a small hole area, the vice itself does not clinically manifest itself, but it concerns only the state of rest. But with increasing blood pressure in such a circle of blood circulation as a small one, dyspnea appears, and patients complain of a strong heartbeat while performing minor physical exertion. In cases of a sharp increase in capillary pressure, cardiac asthma develops, a dry cough, and sometimes with the separation of sputum and even in the form of hemoptysis.

With LH( pulmonary hypertension), patients become weak and quickly get tired. With severe symptoms of stenosis, there are signs of mitral blush in the cheeks with a pale complexion, cyanosis on the lips, nose and ears.

During a visual inspection with mitral heart disease, a strong protrusion of the sternum of the lower part and a pulsation are observed as a result of the formation of the humerus of the heart, which is the result of increased strokes of the prostate on the chest wall in front. In the region of the cardiac apex, the diastolic tremor in the form of cat purring is determined. At auscultation, listen to the strengthening of the first tone in the upper part of the heart and click when the mitral valve opens.

Mitral stenosis can occur in several stages. The first is full compensation, in which you can do without the use of surgical treatment. The second is congestion in the LH( pulmonary artery).In this case, surgical treatment is performed strictly according to the indications. The third is the insufficient work of the pancreas. Absolute indices for conducting operative intervention are noted. The fourth stage is characterized by dystrophic changes. With the use of drug therapy it is possible to achieve an insignificant, short-term effect. At this stage, operations can be performed, however, prolonging the life span of patients for a short time. For the last, terminal stage, any treatment does not give any effectiveness, neither medicamentous, nor operative.

The second type of mitral heart disease is considered insufficient work of the mitral valve. To date, in the modern world, 61% of this disease falls on degenerative mitral insufficiency and only 14% is rheumatic pathology. Other reasons for the development of this heart defect include systemic scleroderma, lupus erythematosus, endocarditis of infectious etiology and coronary heart disease.

This disease is classified into an initial severity, moderate and severe.

In compensation this type of heart disease is accidentally detected during medical examination. With reduced work of contractions of the LV, bouts of labored breathing develop when performing certain work and heartbeats. Then edema on the legs, pain in the hypochondrium from the right side, cardiac asthma and even shortness of breath into the states of the absolute so far.

Many patients diagnose aching, stitching, pressing pain in the heart, which can appear without physical exertion. With significant regurgitation processes in the left part of the sternum, patients are noted to form a heart hump, a jolt is heard in the upper part of the heart of an intensified and diffuse character that is localized under the fifth rib. When auscultation is completely absent the first heart tone, over LA very often splits the second tone and at the top - a deaf third tone.

In mitral insufficiency, five stages of the disease are also distinguished. The first is the stage of compensation, without indications for surgical methods of treatment. The second is the subcompensation stage, for which surgical intervention is necessary. The third stage of mitral insufficiency proceeds with decompensation of the prostate. Here, also, the operation is scheduled. The fourth is a dystrophic change in the heart. In this case, it is still possible to conduct operational interventions. The fifth stage is terminal, in which surgical treatment is no longer performed.

The prognostic parameters of poor outcomes include the age of patients, the presence of certain symptoms and atrial fibrillation, progressive LH processes and low ejection fraction.

Heart disease treatment

As a rule, the treatment of heart disease is divided into medical and surgical methods. In the phase of compensation for cardiac malformations, no special treatment is prescribed. It is recommended to reduce physical activity and mental fatigue. Exercise in the LF group remains an important point. But in the decompensation period, antihypertensive drugs are prescribed to prevent pulmonary hemorrhage;Beta-adrenoreceptor blockers and endothelin, which reduces the emerging functional heart failure, which also allows you to carry physical loads. Anticoagulants are used in the development of fibrillation and atrial flutter.

For decompensation of heart disease, such as mitral malformation, digitalis preparations are used;With aortic defects - Strofantin. But in general, when the conservative methods of treatment are ineffective, they resort to surgical operations with various heart defects.

In order to prevent the development of heart defects of the acquired character, it is necessary to treat diseases such as atherosclerosis, rheumatism, syphilis in a timely and thorough manner, to eliminate infectious foci in the oral cavity and pharynx, and not to overstrain and prevent overloads of nervous character. In addition, it is important to comply with sanitary and hygienic rules in everyday life and work, to deal with dampness and hypothermia.

To the heart disease did not go into the stage of decompensation, it is necessary not to overeat, rationally distribute the work and rest time with sufficient time for sleep. Various heavy types of work, people with heart defects, are absolutely contraindicated. Such patients are constantly on the account of cardiologists.

Heart disease operation

In certain cardiosurgical clinics, various methods of surgical interventions are used to treat heart defects. In case of insufficient functioning of the valves, in some cases resort to organ-preserving operations. In this case dissect spikes or splice. And with minor constrictions, they are partially expanded. This is done using a probe, and the method refers to endovascular surgery.

For more severe cases, a technique is used to completely replace the heart valves with artificial ones. With large forms of aortic stenosis and when the aorta can not be expanded, a resection is performed and a specific aorta site is replaced with a synthetic dacron prosthesis.

When diagnosing coronary artery insufficiency, the method of shunting arteries, which have lesions, is simultaneously used.

There is also a modern method of surgical treatment of heart disease, which is developed and widely used in Israel. This is a rotablater method, which is characterized by the use of a small drill, which allows to restore the lumen of the vessels. Very often heart defects are accompanied by rhythm disturbances, i.e.blockades are formed. Thus, the operation with the replacement of the valve is always accompanied by the implantation of artificial control and regulation of the rhythm of the heart.

After carrying out any surgery for heart defects, patients are in rehabilitation centers until they complete the entire course of therapeutic restorative therapy with thrombosis prevention, improved myocardial nutrition and treatment of atherosclerosis.

After discharge, patients periodically undergo examinations for the appointment of a cardiologist or cardiac surgeon with preventive treatment twice a year.