Mitral stenosis (stenosis of the mitral valve): symptoms and treatment
Mitral stenosis or stenosis of the mitral valve is a dangerous disease of the cardiovascular system. The pathological process leads to a violation of the natural outflow of blood from the left atrium to the left ventricle. In other words, the hole between them narrows. In the main risk group, women aged 40-60 years. But the male half of the population is also susceptible to this type of cardiovascular disease. According to statistics, the disease is diagnosed in 0.5-0.8% of the world’s population.
The most common cause of the development of the pathological process is rheumatism. It is noteworthy that the disease can begin to develop asymptomatically. The first signs of mitral stenosis may appear after 10-15 years from the onset of the development of the disease. Naturally, this circumstance considerably complicates the treatment process.
In addition, mitral stenosis can be formed due to the following factors:
- trauma to the heart or chest;
- infective endocarditis;
- Infirmious diseases
- intracardiac thrombi.
In more rare clinical cases, stenosis of the mitral valve may be due to congenital pathologies. But, as medical practice shows, in 80% of cases, the acquired stenosis of the mitral valve is diagnosed in patients.
Against the backdrop of such a vice, other ailments can form. The most common is aortic insufficiency.
At the initial stage, the ailment can not at all give symptoms. As the disease develops, the following symptoms may occur:
- increased fatigue;
- dyspnea, even with light loads
- cough with a trace of blood
- arrhythmia or tachycardia
- Asthma attacks at night.
In later stages of the disease, the signs of mitral stenosis may be more pronounced. Especially the doctor can detect irregularities in the work of the heart with the help of auscultation. At a late stage, dyspnea in humans is observed even in a state of rest. Symptoms of asthma become more frequent, and not only at night.
This symptom, like shortness of breath — is the first and most reliable sign of ailment. But, at the same time, such a symptom, as well as hemodynamics, can indicate other diseases. Therefore, you should consult a cardiologist for an accurate diagnosis.
Gradually, the appearance of the patient also changes. There is cyanosis of the lips and even fingertips. On cheeks can appear an unhealthy blush. These are also characteristic symptoms of the disease.
Mitral stenosis can be fatal if not treated in time. According to statistics, this disease leads to death in 40% of cases.
Forms of ailment
In official medicine, there are three stages in the development of the disease. They are diagnosed depending on the area of the mitral orifice:
- light form — an opening of at least 2 and not more than 4 square centimeters
- moderate — a hole from 1 to 2 square centimeters
- Heavy — hole less than 1 square centimeter
As a rule, the mild form of mitral stenosis proceeds without any symptoms. Diagnosis of the disease can be accidental — during the research of other diseases.
Stages of development of the disease
In total, clinicians distinguish five stages of development of mitral stenosis:
- First — Full compensation. There are no signs of disturbances in the work of the heart;
- Second — violation of circulation of blood in a small circle. Symptoms can be observed only with increased physical exertion;
- Third — stagnation of blood in a small circle and disorders in a large circle of blood circulation
- Fourth — Severe circulatory disturbances in the cardiovascular system, symptoms of initial failure, well audible by auscultation
- The fifth is a dystrophic stage. There are signs of acute heart failure.
It is worth noting that complications can occur at any stage of the disease. In this case, everything depends on the general condition of the patient, his age and the clinical picture of the disease.
If the symptoms manifest in the body, you should immediately contact the cardiologist to get the diagnosis and confirm or deny the presence of pathology in the body. The fact is that the manifestation of these symptoms does not mean that the patient has mitral stenosis. Therefore, making a diagnosis of yourself is unacceptable in any case.
Diagnosis of ailment consists of personal examination, auscultation, laboratory and instrumental methods of research.
Initially, an anamnesis is revealed when exactly the symptoms began to appear and whether the factors that preceded it were excessive physical exertion, stress, transferred operations, and so on. Be sure the doctor conducts auscultation (listening to the heart). The auscultation method allows you to pre-diagnose before a more in-depth diagnosis is performed.
The standard program for diagnosis of mitral stenosis includes the following:
- physical examination — personal and family history, auscultation
- a general blood test;
- general urine analysis
Based on the results of this survey, the following procedures can be prescribed:
- biochemical blood test
- coagulogram (blood coagulation test).
In addition, instrumental analyzes are required:
- ECHO (echocardiography)
- Chest X-ray;
- Transesophageal echocardiography — as the food probe passes very close to the heart, this method of examination allows you to see the shape of the heart and the size of the mitral hole.
ECG-study, if suspected of such a pathological process, is mandatory. Auscultation may indicate only about the extent of the lesion. By the way, ECG-study is mandatory, if there is a suspicion of violations in the work of the cardiovascular system.
In addition to these methods of research and advice from a cardiologist, you may need to consult a rheumatologist and a cardiac surgeon. Such appointments the doctor can give only if the narrowing of the hole has reached a moderate or severe shape.
If the patient is diagnosed with mitral stenosis, then the treatment of this ailment can be of two types — conservative or operable. In most cases, surgical intervention is used if the hole is less than 2 square centimeters and acute heart failure is observed.
In addition to taking narrow-spectrum drugs to treat stenosis of the mitral valve, the patient is prescribed a special diet.
It is worth noting that medications do not eliminate the disease. They only remove common symptoms and inhibit the development of the pathological process. The doctor prescribes preparations of this spectrum of action:
- beta blockers — to prevent emotional overload and stress
- diuretics (diuretics);
- antiarrhythmic drugs — to restore the natural rhythm of the heart
- antibiotics — to prevent the formation of an infectious process
Also for the period of medical treatment of mitral stenosis the patient is prescribed a full course of necessary vitamins and minerals. In addition, it is necessary to exclude physical activity.
Surgical method of treatment
Treatment of mitral stenosis by surgical method is used if the mitral opening is less than 2-3 square centimeters. Especially, surgery can not be postponed if the patient has acute heart failure.
Three types of surgery are used to treat mitral stenosis:
- Percutaneous commissurotomy
- open commissurotomy of the mitral orifice;
- closed commissurotomy of the mitral orifice.
If a severe damage to the valve is diagnosed, then prosthetics are used — replacing the native valve with an artificial one.
After the operation, the patient needs to undergo a long rehabilitation course. Since it is possible the formation of infectious endocarditis and heart failure, the patient is prescribed an additional course of drug treatment. Including antibiotics.
Be sure to monitor a cardiologist. At each appointment, the doctor can use the auscultation method to promptly diagnose possible complications. Periodically, the patient needs an ECG test.
Treatment of mitral stenosis at an early stage implies a special diet. It is necessary to completely eliminate from the diet the use of such products:
- fried and smoked
If a person smokes, then this should be deleted, but gradually. Sharp refusal of nicotine can serve as a strong stress for the body.
If you do not start treatment in time, then possible complications with mitral stenosis:
- acute heart failure;
- cardiac asthma (left ventricular failure)
- increased pressure in the pulmonary artery
- heart rhythm disorder
- Clogged blood vessels with blood clots (this can lead to death)
- pathological enlargement of the left atrium.
The latter can lead to compression of the nerve endings and near organs. This complication entails other diseases.
It should be taken into account that complications of mitral stenosis are possible only if the treatment is not started in a timely manner.
As a rule, a correct course of treatment and surgical intervention give good results. Complications or the occurrence of other background diseases — cardiac, left ventricular failure is not observed.
With a timely operation, the survival rate is 85-95%. In the natural course of the disease, the survival rate is not more than 50%.
Completely eliminate this disease is impossible. But some measures to reduce the risk of a pathological process, you can take. To do this, one should apply in practice such simple rules:
- full nutrition, with a full range of vitamins and minerals
- moderate exercise;
- walks in the fresh air, full rest.
If not completely eliminated, then at least reduce stress and nervous situations in your life.
It is very important to begin treatment of angina in time. It is this disease that can provoke the ailments associated with the cardiovascular system. Monitor your health and seek medical help in a timely manner.