The narrowing of the left atrioventricular holes

The narrowing of the left atrioventricular holes (synonym: narrowing of the left atrioventricular holes, mitral stenosis) is caused by the accretion of the valves of the mitral valve (Fig. 7 and 8).

Fig. 7 - 9. A change of heart when narrowing of the left atrioventricular holes. 1 - the right atrium; 2 - the left atrium; 3 - butterfly valve; 4 - the left ventricle; 5-right ventricle; 6 - tricuspid valve; 7-semilunar valve of aorta; 8 - semilunar valve pulmonary trunk; 9 - border hypertrophied infarction; 10 - border extended cavity ventricle; 11 - projection borders healthy heart; 12 - projection borders of the heart at the blemish; 13 - the best place listening to the noise.

Due to narrowing atrioventricular holes of the blood during diastole not have time to pass from the left atrium into the left ventricle. Thus, the atrium is overloaded blood, expands and hypertrophies. Occurs stagnation in the pulmonary circulation, which leads to hypertrophy of the right ventricle. The left ventricle remains underutilized and performs less than normal, the work that conducts to decrease (atrophy).
Patients complain of shortness of breath when driving, palpitations, sometimes pain in the heart area. Often hemoptysis, due to the stagnation in the small circle of blood or heart attack the lungs.
Objective examination observed cyanotic flushed cheeks and the blueness of the protruding parts of the body (acrocyanosis), visible ripple in the epigastric region as a result of expansion and hypertrophy of the right ventricle. The apical jerk is not expressed. At a palpation of the apex of the heart often determined diastolic shake ("cat purring"). Heart expanded up and right due to the expansion of the left atrium and the right ventricle (Fig. 9). The first tone at the top loud clapping due to insufficient filling of the left ventricle blood. Often on the upper heard the tone for the opening of the mitral valve arising from sudden voltage thickened valve at the time of its opening; it is treated as an echo of the second tone. Over the apex of the heart with mitral stenosis heard of the so-called rhythm quail - first clapping tone and two second tone, and see diastolic murmur. Sometimes he heard only in the early diastole, (prettiesiski noise), more often at the end of diastole immediately before the systole (presistolic noise).
The second tone of the pulmonary trunk significantly strengthened as a result of increased pressure in the pulmonary circulation and often doubled due to the timing of closing of the valves, the aorta and the pulmonary trunk.
For this heart defect characterized by small heart rate, decreased increased systolic and diastolic blood pressure, atrial, arrhythmia (see heart Arrhythmia).
Stenosis of the left atrioventricular holes refers to serious flaws, as the opening is more limited and often comes decompensated heart.
The question of the preservation of pregnancy in this heart defect must be solved only by the doctor, strictly individual. Pregnancy can be saved only in cases of minor degree of stenosis, no events decompensation.