Medical Health Information

Acute onset mitral regurgitation and acute wheezing and optionally water into the lungs. In chronic gradient experienced wheezing with light exertion, later at rest and at flat rent. It reduced pumping of blood may lead to general fatigue and lethargy.

The doctor may hear a murmur (sound not normally be present) when listening with the heart. The heart becomes larger, which is a heart failure character. Often, there is a flicker in the antechamber (disorganized electrical activity, antechamber withdraws not together) with irregular.

ECG, which represents the heart's electrical activity, may show the flicker in the antechamber and any signs of enlargement of the left atrium. Radiograph of the chest may show signs of fluid accumulation in the lungs, enlargement of the left ventricle and left atrium may. Kalk Impact of mitral valve may also appear. The diagnosis is made with certainty by ultrasound (echo-Doppler) of the heart. This procedure can be seen flaps and measure blood flow in the leakage area.

How are mitral regurgitation?
The goal of treatment is to prevent or reduce a possible enlargement of the left ventricle.

Symptoms treated with medication, but patients with symptoms of regular physical activity should be evaluated for possible surgery and the insertion of a mechanical heart valve. Both replacement and attempt to repair the valves may be proper. For moderate to severe mitral klaffs vikt it is appropriate that you limit your activity and avoid peak loads.

Pharmacotherapy
Heart failure can be treated with diuretics, digoxin (improves the heart's ability to contract), a beta blocker (lowers the heart rate, among others) and ACE inhibitor (lowers blood pressure and reduces the back flow of blood to the heart). Chronic flicker in the upper chambers must be treated with drugs that reduce blood clotting in terms of the risk of blood clots.

Preventive treatment
After insertion of the prosthesis is given drugs that inhibit blood clotting. Mechanical prosthetic requires lifelong treatment. Using the biological prosthesis (from another species) is not required to always lifelong treatment.

After surgery with artificial valve recommended preventive antibiotics by some surgical procedures that can lead to the huge outflow of bacteria into the blood. This includes surgical dentistry, or surgery of the inflamed tissue in the oral cavity or upper respiratory tract.

Mitral regurgitation
Mitral valve is the name of the heart valve between the left ventricle, and the flap should normally prevent blood from flowing back into the left atrium when the heart chamber contracts. When blood flows in the wrong direction through the flap, there mitralklaffsvikt.

This is the second most common valve defect, by narrowing of the aortic valve (the valve to the aorta). Mitral klaffs vikt often seen as an additional phenomenon to enlargement of the left ventricle in heart failure (valve apparatus is put on stretch).

What causes mitral klaffs vikt?
Mitral klaffs vikt can have many causes. However, often it is associated with injury due to hypoxia, such as in myocardial infarction. An infarction can cause the threads to hold the flaps in position is too slow or described above. The muscles that tighten and control wires to the valves can also be damaged. Disorders of the connective tissue in the heart can as well cause failure flap function. Previously, rheumatic fever, a common cause, but this is now very rare.

Mitral klaffs vikt can also be congenital.

How is a long-term outlook at mitralklaffsvikt?
If cardiac function is not damaged before surgery, life outlook is good after surgical treatment. All patients suspected of this disease will be referred to a cardiologist, to set definite diagnosis and assessment of timing of surgery.

The increased load on the heart because of the leak can be in the longer term provide enlargement of the left ventricle and atrium. The increased pressure is obtained in the antechamber may propagate into the pulmonary circulation and provide an elevated pressure here, which in turn can lead to failure also in the right half. Long-term outlook depends on the severity and cause. Acute rupture of wires or muscle flap in the appliance, or inflammation of the heart valves, have poorer prognosis.

In acute mitral klaffs vikt may cause serious respiratory problems because of the severe buildup of water from the lungs and development of shock.

How diagnosed?
Diagnosis can be difficult to set. Knowledge of the patient is in a risk group, combined with symptoms such as loss of appetite, weight loss, malaise, chills, nausea, vomiting and night sweats - suggestive of the disease.

Sometimes the doctor may find that there is a murmur over the heart or a previous heart murmur has changed. Blood tests, X-rays of the chest, ultrasound of the heart and electrocardiography (ECG) help to determine the diagnosis. Detection of bacteria in blood confirmed the diagnosis.

How is your condition?
The treatment takes place in a hospital. The aim of treatment is to eradicate the bacteria that cause the disease and reduce the risk of getting the disease later. It is given various antibiotics, which are drugs that kill bacteria.

Drugs administered before the start directly into the bloodstream (intravenously), and the processing time is often 4-6 weeks. In up to half of cases it may be necessary to perform an operation after antibiotic treatment has ended, where one replaces the diseased heart valves with artificial valves (valve prostheses).

Infectious endocarditis can result from a variety of organisms, but most frequently are streptococci, which is a bacterial species that is normally present in the oral cavity. The disease can also be caused by other bacteria and fungi (candida). The bacteria usually come with blood flow to the heart, where they settle on the heart valves. It multiplies itself and generally, form's wart-like growths. These growths can loosen, and entered the bloodstream that bacterial blood clots (bacterial emboli). The valves damaged by inflammation, which may cause the valves to leak and the pumping work is heavier, at worst so complicated that it becomes a life-threatening condition.

Approximately, two-thirds of the patients have some cardiac defect, such as congenital heart defects, prior to infection. Such a heart defect may be undetected until endocarditis occurs.

People with special risk for endocarditis, patients with artificial heart valves (dentures), with heart failure caused by certain rheumatic diseases, congenital heart defects, other defects of the heart valves, previous infective endocarditis, impaired defense against infection, patients hospitalized catheters or electrodes in the veins, intravenous drug abuse.

There have been major changes in the causes of endocarditis. Chronic rheumatic heart disease is today in Western countries an unusual cause more common causes in our day and valvular disease in the elderly, intravenous drug abuse, insertion of artificial valves, instrumentation inside the blood vessels along with increased incidence of Staphylococcus infections. New bacteria detected, and multi-resistant bacteria make treatment more difficult.

Infective endocarditis is a bacterial infection (infection) in the choroid (endocardium) inside the heart, where the infection (bacteria) usually comes with blood flow. Heart valves, which are covered by the choroid, attacked. These flaps have the task of separating the heart chambers from each other as one-way valves, and for damage to the pumping work will be complicated.

The disease is both an acute, fast-advancing form and in a subacute form, the symptom's somewhat longer time to develop. Symptoms of the disease may be poor appetite, weight loss, malaise, chills, nausea and vomiting and night sweats.

In the Western world, the incidence of infective endocarditis from 1.7 to 6.2 per 100,000 patients per annum, ie a rare condition. The incidence is 10 times as high among drug users (IDUs) as in the general population. In patients with the heart valve prosthesis, the incidence is even higher.

Living with infective endocarditis
People belonging within a risk group for endocarditis (because of congenital heart disease, acquired valve disease, valvular prostheses or previously undergone endocarditis) will in some cases have prophylactic treatment with antibiotics before surgery, which may cause it comes bacteria from the blood (bacteremia) . Such interventions are primarily dental treatments and procedures in the oral cavity and pharynx.

How is the condition over time?
Infective endocarditis is a fatal condition without treatment. With treatment survives 70-80% of patients.

Complications
The infection can be difficult to deal with.
Bacterial blood clots can break loose from the flaps and carried by the bloodstream to the lungs or other parts from the body, where they can get stuck in blood vessels and cause damage.
The affected valves can crack, allowing the heart has major problems with its pumping work.
There may be blisters on the heart wall that can rupture.

How do you treat a narrowing of the aortic valve?
The goal of treatment is to correct the valve problem and treat complications. It has been customary to wait until the patient experience's symptoms before doctors recommend surgery. Recent knowledge indicates that the best results are achieved if one can operate just before you start getting symptoms. Therefore, it is important that you are thoroughly examined when a murmur is detected. Can doctors whom you have a narrowing of the aortic valve, and this narrow area is quite pronounced? It will be set up a monitoring program for you? Generally, you will subsequently be instructed to attend regular check-ups with 6 to 12 months. Then it gets done echocardiography and stress testing. Can doctors whom the condition is deteriorating, you will be recommended surgery?

Otherwise, you can limit your risk of developing heart disease by stop smoking and reducing the intake of saturated fat. Furthermore, you should avoid large effort by proven narrowing of the aortic valve.

Pharmacotherapy
Beta blockers to lower the heart rate and reduces stress to the heart may be necessary to provide if the left ventricle is functioning normally. Postoperative given drugs which lower blod supply trends, thus preventing blood clots. The drug that prevents inflammation of the heart valves (endocarditis) are required during certain surgical procedures in patients with implanted prosthetic valve (endocarditis prophylaxis) . In the years before being operated are so antibiotics are not necessary.

How to diagnose narrowing of the aortic valve?
Usually it takes a long time for the condition to cause symptoms. The most frequent symptoms occur gradually, breathing difficulty, chest pain, dizziness and fainting, especially on exertion. Previous rheumatic fever is an important piece of information.

A physical examination is heard a murmur over the heart in the pumping phase (sound not normally be present). The sound propagates the neck vessels, that the doctor can hear the murmur of the arteries in the neck. Cardiac shock to the chest wall can be stronger than normal.

Flap error can thus be detected by this murmur long before you notice that something is wrong.

Other studies
ECG (preparation of the heart's electrical activity) can show rotation of the heart's electrical axis, thickening of the heart muscle and / or block the electrical impulse line. None of these findings are evidence against the existence of aortic stenosis. Radiographs of the chest can show calcium in heart valve and ev. broad root in the aorta. Ultrasound of the heart is the most important examination, echocardiography, and this also provides information regarding the severity of the stricture. Radiographs Preparation of cardiac arteries may as well be necessary before an operation.

How is long-term prospect by narrowing of the aortic valve?
The condition is detected by random discovery of murmur, or symptoms. If untreated the condition may progress to heart failure within a few years. Heart failure may develop suddenly or gradually. Many people develop chest pain on exertion (angina or angina pectoris ). Complications can be fainting, exertional chest pain, heart failure and cardiac arrest.

If you get diagnosed early - before symptoms set in - you can operate before flap error getting done greater damage. After surgery, you will be healthy, and the life is roughly equal to that of peer people. The risk of complications during surgery is nowadays very small.