二尖瓣狭窄
定义
Mitral stenosis is a narrowing of the mitral valve in the heart. 这 is a valve on the left side of the heart that connects the top chamber called the atrium to the bottom chamber called the ventricle. Blood flows from the atrium through the mitral valve into the ventricle before being pumped out into the rest of the body.
Mitral stenosis can result in poor blood flow between these two 左室. 这 can reduce how much blood and oxygen is getting to the rest of the body.
| Mitral Valve Stenosis |
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原因
The most common cause of mitral stenosis is 风湿热, because it can scar the mitral valve. 一些 congenital heart defects may also affect the mitral valve and how well it works.
Less common causes of this problem 包括:
- Bacterial endocarditis
- 血凝块
- Tumors or growths that block blood flow
风险因素
Mitral stenosis is more common in women. It often appears in adults between of 30 and 50 years of age. Other things that may raise the risk of mitral 狭窄:
- A history of 风湿热 or a lot of strep infections
- 心 valve problems present at birth
- A family history of mitral stenosis
- Other health problems, such as high blood pressure, chronic kidney disease, 冠状动脉 动脉疾病 (CAD)
- A history of radiation treatment to the chest
- 静脉注射药物
症状
Mitral stenosis may cause:
- Trouble breathing, especially while working out and when lying flat
- Waking up short of breath in the middle of sleeping
- 疲劳
- Fast or irregular heartbeat
- Cough when doing something that takes effort
- Coughing up blood
- Swelling of the legs or feet
- Lightheadedness and fainting
- Chest pain, such as squeezing, pressure, or tightness (rare)
诊断
The doctor will ask about symptoms and past health. 一个物理 exam will be done. It will focus on the chest and heart.
Pictures will be taken of the heart and chest. 这 can be done :
The heart's electrical activity may be tested. 这 can be done :
治疗
The goals of treatment are to manage symptoms and make sure the heart rate stays in a 健康的范围. People with mild mitral stenosis may only need monitoring. 如果症状 get worse the doctor may advise avoiding intense activity and foods that have a lot of 盐.
治疗 options are:
支持性护理
一些 steps that may be advised to manage mitral stenosis 包括:
- Limiting 盐 intake
- Limiting caffeine and alcohol
- Physical activity
药物
Medicines can help manage symptoms. The doctor may advise:
- Medicines that lower the heart rate and help the heart work better
- Diuretics to prevent fluid buildup
- 血液稀释剂
- Drugs to control heart 节奏
Antibiotics may need to be taken for certain infections. 这 will help prevent more harm to the heart. They may also be needed before medical and dental procedures.
手术
Common types of heart valve surgery are:
- Mitral valvulotomy—The stenotic mitral valve is cut to ease the obstruction.
- 气球 瓣成形术—A balloon device is put into the blocked mitral valve to open it or make it bigger.
- 二尖瓣 更换—这 is for people with severe symptoms or when other treatments have not helped.
预防
To lower the risk of mitral stenosis:
- Get treated right away for any possible infections, especially 链球菌性喉炎.
- Manage chronic health problems.
参考文献
- Antibiotic prophylaxis for heart patients. 口 Healthy—American Dental Association website. 可以在: http://www.mouthhealthy.org/all-topics-a-z/antibiotic-prophylaxis-for-heart-patients.
- Infective endocarditis. EBSCO DynaMed website. 可以在: http://www.力学.com/condition/infective-endocarditis.
- Mitral stenosis. EBSCO DynaMed website. 可以在: http://www.力学.com/condition/mitral-stenosis.