Mitral valve prolapse 2nd degree is srednevyrazhennymi changing one of the structures of the heart that prevent backflow of blood in it.
To estimate the probability of getting into the army with the diagnosis and symptoms, treatment and prognosis will help understanding the anatomical causes of pathology and risk of complications.
The path of oxygen-rich blood passes through left atrium and ventricle into the aorta, then to the organs. The unilateral passage of that path regulate valves, including the mitral. He restrains the reverse flow of blood by closing the valves. This feature is not feasible when the deflection of the valves inside the atrium, the formation of prolapse.
The amount of deflection there are three degrees of prolapse:
- 1 is a deflection of 2-5 mm;
- 2 — 6-9 mm;
- 3 — 9 mm.
Prolapse of 1 degree does not require treatment, it is favorable and does not cause discomfort.
What is 2 degree and how does it differ from the first?
In the clinical picture and frequency of complications prolapse 2nd degree is a little different from the first. Anatomical differences are manifested in the deflection of the sash further to 1-4 mm, arising from structural features of the chambers of the heart or dysfunction of the connective tissue component of the structure of regulation of fixation of work the valves.
The nature of valvular deformation
What is mitral valve prolapse of 2 degrees, it will become clear, if a little deeper into the anatomy.
The folds of the valve are connected to the papillary muscles of the myocardium of the ventricle chords.
In normal operation of the valve is described by the paragraphs from each other:
- The ventricle, the pressure inside increases.
- Papillary muscles are connected to the chord pull sash;
- The valve is closed.
The prolapse of the valves is limited by the chordae attached to papillary muscles. The closer these structures are located to the atrium, the less limitations. Therefore, the ventricular volume directly depends on the depth of the trough. Its form varies with different body position. This is related to some detection methods, which detect the level of disease progression, when listening to the heart of the person lying, sitting and in standing position.
Chords are directly connected with the doors, so when they breach, loss of elasticity and strength, also occurs deflection. The nature of chords and the valves — connective tissue, respectively the theory of the formation of mitral valve prolapse are built around violations of the structure of connective tissue.
- theory of valvular deformations leading to modern medicine. It talks about the genetic nature of the pathology of connective tissue. Research in this area is still in progress, but for 2015 have already been identified mutations of the gene responsible for the protein synthesis of filamina And that is associated with the causes of prolapse;
- magnesium deficiency regulates collagen fibers, renewing tissue. It also supports muscle tone.
Full prevent back flow of blood occurs. In a healthy person and a person with prolapse varies only the amount of blood, spitting back into the atrium. The transfer process of blood in opposite the normal flow direction called regurgitation.
The severity of regurgitation
With the severity of heart failure correlates qualitative assessment of the degree of regurgitation:
- 1 — spread to the fibrous ring;
- 2 — until the middle of the atrium;
- 3 — more than half;
- 4 — to the opposite wall.
At small degrees of regurgitation symptoms are mild or absent, higher progress. This fact is due to the fact that due to partial outflow of blood back into the atrium, further reducing the ventricle receives more blood than it is capable of. There is an increase in ventricular volume, causing the symptoms of the disease is not manifest.
When the compensatory ability of the ventricle runs out and he loses the ability to cope with the load, the volume of pumped blood is reduced. Begin to show symptoms. Prolapse 2nd degree with regurgitation of 2 degrees and above enough reason to consult a doctor.
Auscultatory symptom is detected when listening with a stethoscope to the heart, it is the phenomenon of systolic click and late systolic murmur. There may be variation even in one and the same patient, due to the different position of the body while listening.
If the picture auscultation revealed no violations, there are complaints that indicate a possibility of prolapse:
- shortness of breath;
- pain in region of heart;
- shortness of breath, cough;
- weakness and fatigue;
- fainting in stuffy rooms;
- palpitations, feeling of heart;
- the heart rhythm disturbance.
From 20-60% of patients with objective symptoms are absent. Diagnosis is difficult due to inaccurate criteria. The advent of ECHOCARDIOGRAPHY has simplified the identification of prolapse even without the clinical and auscultatory symptoms, which is a large percentage in the population this disease (3,8%). Based on modern criteria, this percentage remains high, but not that much.
The risk of complications and death in pathology
Most people diagnosed with prolapse, healthy people. Even in severe regurgitation, identified by echocardiography complications may not be, however, mechanical or infectious lesions of the valve regurgitation can progress to such an extent that no surgery will not do.
Regurgitation 2 the degree of the prolapse 2nd degree dangerous, because of the accompanying pathology of arrhythmias can lead to sudden death. There is ventricular fibrillation, when due to frequent palpitations of the ventricles is reduced in vain, is not pumping blood. Blood pressure falls and blood flow to the organs is disturbed.
The death rate is 1.9 per 10,000 patients per year — no significant mitral regurgitation. It is associated with thromboembolic stroke.
Is it permissible exercise?
Patients, diagnosed with mitral valve prolapse of 2 degree with a regurgitation of 1 degree, without the expressed symptoms, even load required. Limit strenuous exercise is recommended during deformation of the ventricle, arrhythmias, in General, serious symptoms. Cardio to cancel it should not, even if they are hard.
Compatible with military service
People diagnosed with mitral valve prolapse of 2 degrees, the question arises — do in the army with this pathology, because the load on the heart and provoke the development of complications. Also stress that is experienced recruits, adversely affects the heart.
A crucial role in deciding about the suitability of the recruit to the performance of military duties is the presence of symptoms.
Their severity depends do in the army with mitral valve prolapse of 2 degrees, since in this pathology, the clinical picture is heterogeneous and variegated. If symptoms are not present or they are not called light loads, the recruit is encouraged, but with restrictions.
When prolapse 2 degrees this does not happen: even at low heart failure, according to the law of the recruit released from military service in peacetime, because physical activity aggravates the symptoms. At medium and higher degrees of severity of heart failure the recruit fits the category of unfitness for military service and exempted from conscription.
Take the army, when the degree of prolapse 2 and less, and regurgitation does not reach the middle of the atrium.
Treatment is aimed at reducing symptoms as medication intervention is the opposite of the disease and surgical method involving the implantation of the prosthesis and plastic valves, not used in the absence of the risk of serious complications.
When mitral valve prolapse of 2 degree with regurgitation, transient ischemic attacks, atrial fibrillation persons under 65 years prescribed aspirin, older and persons who suffered a stroke on the background of mitral regurgitation shown anticoagulant therapy. Metabolic therapy is the supplementation of magnesium and is also included in the treatment of mitral valve prolapse of 2 degree.
- Prolapse, even appearing at an early age does not cause discomfort until the outflow of blood kompensiruet.
- Sports have a beneficial effect on the heart, although for military service persons with this syndrome are not always allowed.
- Treatment if assigned, rarely is surgical intervention.