Heart murmurs in adults

What are heart murmurs in adults?

We all read or heard talking about heart murmurs in adults, and many of us are curious to find out if  they have this dysfunction. A few know the true meaning of this condition, that’s why when our physician tells us we have  heart murmurs either we think we suffer from a devastating disease, either we ignore it, but none of this reaction is normal.  Next we will clarify the meaning and the cause for heart murmurs, in order to prepare people that might be diagnosed with this disorder to understand and deal their condition properly.
Heart murmurs in adults refer to the abnormal sounds heard by doctors when they listen to the heartbeats with a stethoscope. In medical practice, hearing  heart murmurs in adults raises the suspicion of heart valve pathology, but sometimes these abnormal heart sounds can occur in other conditions like a defect in the heart wall, anemia, fever etc. When there is no heart modification that can explain the murmurs, they are called functional. Because this condition can occur in other pathologies beside hear disorder, everytime we suspect a heart murmurs in adults we should check its presence with an echocardiography examination.
Heart murmurs affect both children and adults and are recognized as the “noise” heard between the two normal heart sounds. If the murmur occurs after the first heart sound is called systolic, which means it occurs during heart contraction, and if it occurs after the second heart sound is called diastolic and this means it occurs while heart is in its relaxation period. The classification into systolic and diastolic is important because it indicates whether we are facing a valve stenosis (narrowing of the heart valve) or insufficiency (the valves fail to close properly, letting blood to flow back into the heart chambers). There are other classifications for heart murmurs in adults, but those medical terms are more important for the specialists.

 Why do heart murmurs in adults occur and how we deal with them?

 As we explained above, in most of the cases heart murmurs in adults occur when there is a heart pathology:

• heart valve narrowing or closure impairment, in this case the blood flow becomes turbulent and makes a noise that we call it murmur,
• a defect in heart wall-a congenital defect that occurs in children, allowing blood to flow from one side of the heart to the other, determining blood with oxygen and blood with carbone dioxide to mix. Sometimes this condition can remain undiagnosed until late adulthood, because it is a small defect and doesn’t cause symptoms, but in many cases is diagnosed soon after birth, being recognized as a prolonged murmur (noise) heard during heart auscultation and needs surgical correction. Another type of heart murmur heard in children is the one determined by the ductus arteriosus persistence (a connection between aorta and pulmonary artery in the uterine life).
• other condition like anemia or fever can determine heart murmurs in adults, because they determine turbulent blood flow, but this murmur disappears once the condition is treated.

How do we  with deal heart murmurs in adults ? In patients suffering from valve pathology periodically monitoring is important because in time they can lead to heart failure, in order to prevent this, surgical replacement of the valves can be performed. Heart wall defect can also be repaired providing a normal life for these patients, while the causes for functional heart murmurs in adults once treated determine these abnormal heart sounds to disappear.

Heart murmurs in adults are a serious medical condition,  if you think you have it call your doctor.

Replacement heart valve surgery

Valvular diseases (lesions of the four valves of the heart) in general have some common characteristics in terms of etiology, symptoms, clinical investigations but also others such as replacement heart valve surgery used in treatment.

Replacement heart valve surgery basics

There are four valves in our heart: mitral valve, aortic valve, pulmonary valve and tricuspid valve. These valves may have opening of valve problems (stenosis) or closing of valve problems (regurgitation). Interventional treatment (especially replacement heart valve surgery) is necessary when patients have symptoms for these lesions.
We can not expect that valve lesions consists have a spontaneously regressive evolution and therefore the most common method of treatment is the replacement hear valve surgery. There are cases when multiple heart valves are affected. The surgery is performed by repairing or replacing the heart valve. Replacement heart valve surgery is surgery that is performed when the valve can not be repaired and the heart valve is replaced with a prosthetic valve. Before replacement heart valve surgery patients will receive general anesthesia during which they will be asleep and will not feel pain. The most replaced valves are mitral valve and aortic valve. There two kinds of valves used for the replacement heart valve: mechanical valves and biological valves. Biological valves may come from pigs, cows or human donor. Biological valves from human donor may be heart valves or pulmonary valve especially for aortic valve replacement. Mechanical valves are much better then biological valves. After replacement heart valve surgery with mechanical valve patients must follow treatment with anticoagulants or with aspirin for the rest of his life.
Mitral stenosis and mitral regurgitation
Replacement heart valve surgery for mitral stenosis is indicated in patients suffering from medium or large stenosis (mitral valve orifice of less than 1 inch or symptomatic patients and mitral valve opening more than 1 inch).  The most common cause of mitral stenosis is rheumatic disease. Prophylactic replacement heart valve surgery for mitral stenosis may be made to women who want to have a child.
Replacement heart valve surgery can also be done for mitral regurgitation. But this can have some disadvantages: first because replaced valve can not function as original valve and second because may be some complications of surgery (embolism, infection in the body, coagulation changes or endocarditis – infections of heart valve).
Aortic stenosis and aortic regurgitation
Aortic valves are different from mitral valves such as structure and function. Replacement heart valve surgery is done both for congenital aortic stenosis and for acquired aortic stenosis. Indications for surgery can be done to symptomatic patients or to patients with moderate aortic stenosis who have other heart surgery.
Replacement heart valve surgery for aortic regurgitation is an easy surgery to replace aortic valve. Mortality of this intervention is quite high.
Complications related to valve replacement are increasingly rare lately and when they occur is necessary a new surgery.

In conclusion replacement heart valve surgery is a very good technique to solve valvular heart problems.

Marfan syndrome life expectancy

When we talk about Marfan syndrome should really talk about Marfan syndrome life expectancy because it is a disease that undiagnosed, timely can lead to the death of the patients.
Marfan syndrome is a genetic disorder (autosomal dominant) characterized by connective tissue damage. This syndrome includes multiple malformations of organs (bones, eyes, skin, intestines, heart and lungs).

Marfan syndrome symptoms

Most of the visible signs or symptoms occur in the skeletal system. The patients  suffering from Marfan syndrome are taller than patients without the disease and arachnodactyly ( very thin and long fingers). Another anomaly in the skeletal system is pectus excavatus (deformity of the anterior wall of the chest which penetrates inside sternum) and scoliosis (abnormality of the spine that consists of spine deformity in the form of the letter S). Other signs include abnormal joint flexibility and sometimes pain in joint.
The most important signs and symptoms  associated with Marfan syndrome are the cardiovascular symptoms. This are mitral or aortic valve prolapse (the most common heart valve abnormality) and aneurysm of the aorta.  Many patients with Marfan syndrom have some type of vision problems of which the most important are myopia (a visual anomaly in which distant objects appear blurred), glaucoma and cataracts. This can severely influence Marfan syndrome life expectancy.

Marfan syndrome life expectancy

Marfan syndrome life expectancy may be different from patient to patient. There is no treatment for the Marfan syndrome, but life expectancy may be influenced by monitoring and treatment of complications that can occur. Marfan syndrome life expectancy increased lately because of the advancement in medical techniques and appearance of new treatments.
Best way to expend Marfan syndrome life expectancy is tracking the aneurysm of the aorta and mitral valve prolapse. This is done by a cardiologist annual control for monitoring the health of the heart valves and the aorta. This is done by performing an ECG or another radiological method for the visualization of the anomaly (such as CT or MRI image). The goal of treatment in Marfan syndrome is to slow the progression of the aortic dilatation and to prevent the dissection of the aorta. Another goal of the treatment is to eliminate arrythmias and diminuate the heart rate.
The skeletal manifestations of this syndrome are also important for Marfan syndrome life expectancy. They can be serious and can affect patients life. To solve these problems are used different kinds of pain medication or muscle relaxants.
Because some of the Marfan symptoms of the spine may be asymptomatic, but serious if are not treated, they can be solved by surgery and thus increase the Marfan syndrome life expectancy.
Lung damage involves spontaneous pneumothorax and Marfan syndrome life expectancy depends on the volume of air in the pleural space.  It may resolve by itself or can be made by chest drainage.
Conclusion

Today patients with this syndrome needs to know is not the end of life and Marfan syndrome life expectancy can be good if patients are addressed in time to the doctor.

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.