Showing posts with label Doppler exam. Show all posts
Showing posts with label Doppler exam. Show all posts

Tuesday, August 14, 2012

Leaking heart valve

Mortality and morbidity thought leaking heart valve are  an important part of cardiovascular pathology.  The main changes in  the study of leaking heart valve involves an evaluation of their function and etiology.
So, rheumatic etiology is declining, while the degenerative and ischemic etiology is growing.
Clinical evaluation methods have the same value (family history, physical examination), but some paraclinical methods ( cardiac ultrasound and Doppler) have an important role.

Types of leaking heart valve

Leaking heart valve may occur at the four heart valve: mitral valve, aortic valve, pulmonary valve and tricuspid valve.
The most common type of leaking heart valve is mitral regurgitation. It is characterized by regurgitation of blood in systole ( contraction of heart) from the left ventricle into the left atrium. There are two causes of mitral regurgitation: acute and chronic. The etiology of mitral regurgitation can be inflammatory, but also degenerative and structural. Chronic mitral regurgitation lead to expansion of left atrium.   Echocardiography provides important information in mitral regurgitation.
Another type of leaking heart valve is aortic regurgitation. It is incomplete closure of aortic valve in diastole (relaxation of heart). Aortic valves are affected primary by acute articular rheumatism, infectious endocarditis and degeneration and it can be acute or chronic.
Two other leaking heart valve are tricuspid regurgitation and pulmonary regurgitation. Tricuspid regurgitation is characterized by regurgitation of blood in systole from the right ventricle into the right atrium because of the incomplete closure of the tricuspid orifice.

Leaking heart valve symptoms

Symptoms of patients with   leaking heart valve depends on regurgitation grade and how to install (suddenly or gradually). Patients with small regurgitation can be asymptomatic. There are some  common  symptoms to the patients with leaking heart valve:
-          dyspnea on effort (shortness of breath or air hunger);
-          cough;
-          angina pectoris on effort (chest pain on effort) or at rest;
-          heart murmur;
-          heart palpitations (heart beats more than 90 per minute);
-          asthenia and adinamie;
-          fatigue;
-          rarely may occur syncope;
-          pale skin on  clinical examination.

Leaking heart valve diagnosis

Positive clinical diagnosis is based on present of heart murmur (systolic or diastolic) with different characters. Most used methods for diagnosis leaking heart valve are echocardiography, chest radiography, electrocardiography and Doppler exam.

Treatment and evolution of patients with leaking heart valve

Treatment of asymptomatic patients with leaking heart valve is not necessary. To the patients with symptoms should avoid exercise and salt. There are also treatments with drugs and surgery for leaking heart valve.
Evolution and prognosis of leaking heart valve depend on the importance blood reflux, of how to install (acute or chronic) and of the etiology. Patients with small or average regurgitation may remain asymptomatic a long time, but patients with complications (infectious endocarditis, atrial fibrillation) have obvious symptoms. Patients with acute leaking heart valve have serious prognosis.

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