Mitral valve prolapse is deflection of one or both of the mitral valve into the cavity of the left atrium during systole of the left ventricle. This is one of the most common forms of violation of the valvular apparatus. Mitral valve prolapse may be associated with other valve prolapse or combined with other small abnormalities of the heart.
Mitral valve prolapse detected in 2-18% of children and adolescents, significantly more frequently than in adults. In cardiac mitral valve prolapse register significantly higher: up to 37% with congenital heart disease, up to 30-47% in patients with rheumatism and up to 60-100% in patients with hereditary connective tissue diseases. Mitral valve prolapse can be identified at any age, including the neonatal period, but most often it was observed in children older than 7 years. Up to 10 years mitral valve prolapse detected with equal frequency in boys and girls. In the older age group, mitral valve prolapse detected in 2 times more often in girls.
Descent isolated primary (idiopathic) and secondary mitral valve prolapse. Primary mitral valve prolapse is associated with connective tissue dysplasia, manifested as other valvular structure (changing the structure of the valve and papillary muscles, the violation of distribution, poor attachment, shortening or lengthening of chords, the appearance of additional chords, etc.).
Dysplasia of the connective tissue is influenced by various pathological factors acting on the fetus during its intrauterine development (gestosis, SARS and occupational hazard of his mother, adverse environmental conditions, etc.). In 10-20% of cases of mitral valve prolapse is inherited through the maternal line.
Secondary mitral valve prolapse accompanies or complicates a variety of illnesses. In secondary mitral valve prolapse, as in the primary, is very important initial inferiority of connective tissue.
For example, he often accompanies certain hereditary syndromes, and congenital heart disease, rheumatism and other rheumatic diseases, Non-rheumatic carditis, cardiomyopathy, some forms of arrhythmia, syndrome, vegetative dystonia, endocrine pathologies (hyperthyroidism), etc. Mitral valve prolapse may be a consequence gained myxomatosis, inflammatory damage to the valve, to break the myocardium and papillary muscles, valvular-ventricular disproportion, asynchronous activity of different parts of the heart, which is often observed in congenital and acquired diseases of the latter.
In the formation of the clinical picture of mitral valve prolapse, of course, involved dysfunction of autonomic nervous system. In addition, it is important the relevant metabolic and micronutrient deficiencies, especially magnesium ions.
Structural and functional disability valvular heart leads to the fact that during systole of the left ventricle is sagging mitral valve into the cavity of the left atrium. When prolapse free of folds, accompanied by incomplete by closing them in systole, auscultation register isolated mezosistolic clicks associated with excessive tension chords.
Leaky contact of cusps of the valve or their divergence in a systole determines the appearance of systolic murmur of varying intensity, indicating the development of mitral regurgitation. Changes in subvalvular apparatus (extension of chords, reduced contractile papillary muscles) and create the conditions for the emergence or strengthening of mitral regurgitation.
Standard classification of mitral valve prolapse does not. In addition to the delineation of mitral valve prolapse in origin (primary or secondary) agreed to allocate auscultation and “dumb” form.
In general, mitral valve prolapse – it is a favorable condition, however, recently proved that this is not a harmless disease, as previously thought. In addition to various degrees of cardiac syndrome, patients may have different cardiac abnormalities, including severe enough.