Mitral valve stenosis

Per 100 000 population, 50-80 patients with mitral valve stenosis are more common in women. The disease is characterized by a slow course. The appearance of symptoms most often occurs in 40-50 years. Congenital mitral stenosis is very rare.

In 80% of cases, the cause of mitral valve stenosis is early rheumatism, and the remaining 20% ​​is due to infectious diseases (infectious endocarditis, heart trauma, etc.). Formed at a young age, more common in women. Mitral stenosis is a disease accompanied by a dysfunction of the valve located between the left atrium and ventricle. The valve opens into the diastole, and through it the arterial blood of the left atrium enters the left ventricle. The mitral valve consists of two wings. With mitral stenosis, the valve cusps thicken, resulting in a decrease in the size of the atrioventricular opening. As a result, blood during diastole from the left atrium does not have time to pump out, and as a result, the pressure in the left atrium increases. Therefore, to ensure normal blood supply to the left ventricle, a number of auxiliary compensatory mechanisms are included. In the cavity of the left atrium, pressure rises (from normal at 5 mm to 20-25 mm Hg. Art.). Due to the increase in pressure, the pressure gradient between the left atria and the ventricle increases, as a result, the passage of blood through the opening of the mitral valve is facilitated.

As a result of increased pressure in the left atrium , pressure in the right ventricle increases further in the pulmonary arteries and in the whole in the pulmonary circulation. Due to the high pressure in the left atrium, the myocardium of the left atrium is hypertrophied. Increased atrial work occurs, with progression, the walls of the right ventricle also hypertrophy. As a result, the pressure in the pulmonary arteries and in the lungs increases.

Due to the high pressure in the pulmonary arteries, there is a complaint of shortness of breath during physical exertion. With increased physical exertion, the blood flow in the heart increases and causes an overstrain of the capillaries, heart walls (due to stenosis of the atrioventricular valve) and normal gas exchange is hampered. As a result, patients complain of shortness of breath during physical exertion. With the progression of the disease, shortness of breath may appear at rest. Obvious pallor of the skin, with a pronounced blush on the cheek with cyanosis. The appearance of acrocyanosis (cyanosis of the tip of the nose, ears , chin ). In patients with high pulmonary hypertension during exercise, cyanosis increases and pallor of the skin appears (ashen skin color)