Acquired heart defects

This defect is most often a consequence of rheumatic endocarditis, which leads to thickening of the mitral valve leaflets and their calcification. In the course of inflammation, the tendon chords and papillary muscles are also scarred and shortened. Left venous outlet, the area of ​​which in healthy people is 4-6 cm²is limited to 0,5-1,5 cm²

The defect is a consequence of the shortening of the valve leaflets or the tendon cords and papillary muscles. This leads to insufficient tightness of the valve during contraction. This, in turn, causes the blood to drain (retreat) from the left ventricle into the left atrium through the incomplete valvular opening. The reason for the valve leakage may also be the expansion of the left ventricle, i.e. relative regurgitation. The cause of mitral valve insufficiency is most often rheumatic disease, and less frequently bacterial endocarditis or trauma or infarct-related rupture of the valve leaflet, tendon cords or papillary muscles. What symptoms? Patients most often complain of dyspnea accompanying physical exertion. When the disease is advanced, dyspnoea also occurs at rest. Patients experience fatigue and paroxysmal palpitations. Pulmonary edema and peripheral circulatory congestion are less common than with the obstruction of the left venous opening. X-rays show an enlargement of the left ventricle, which shifts the apex shock to the left and down. What treatment? If necessary, patients are implanted with a valve prosthesis or undergo a valvuloplasty procedure, i.e. the widening of the valve ring. People who do not experience any discomfort due to mitral valve insufficiency must protect themselves against infections, recurrences of rheumatic disease and lead a hygienic lifestyle. photo: Shutterstock

The essence of this heart defect is the return of blood from the aorta to the left ventricle during the relaxation of the heart muscle. The cause of the defect is inflammatory changes in the aortic valve caused by rheumatic disease. Less frequently, such changes occur in the course of syphilis, bacterial endocarditis or trauma. Valve regurgitation may accompany ankylosing spondylitis. The blood withdrawing from the aorta increases the diastolic volume of the left ventricle and causes an increase in post-diastolic pressure within it. Over time, this leads to left ventricular hypertrophy. The heart can reach considerable size. Then it is referred to as the so-called free heart. What symptoms? At the beginning of the disease, patients may not feel any discomfort and lead a very active lifestyle, including heavy physical work and sports. When the condition worsens, there is a strong heartbeat, dizziness and even short-term fainting as a result of transient ischemia

It may be an acquired defect, but it also happens that we are born with a narrowing of the left arterial outlet. The most common cause of the acquired stenosis is rheumatic disease. Acquired stenosis diagnosed after the age of 50 seems to be a separate form of the disease because it is characterized by calcium deposits on the valves. It is still an unresolved question whether valve calcifications in this group of patients are degenerative or develop secondary in the damaged valve due to the ongoing inflammatory process in the body. What symptoms? This defect may not cause any discomfort. When the defect worsens, dizziness and headaches appear. They have visual disturbances, fainting and even fainting. In over 50 percent. patients suffer from coronary pain associated with reduced blood flow through the coronary vessels. Cardiac ischemia can cause other ailments – arrhythmias, ventricular fibrillation. Later in the disease, exercise and rest dyspnoea may appear, as well as episodes of pulmonary edema which are indicative of left ventricular failure. Characteristic for this defect is the behavior of the pulse, which has a small amplitude, slowly increasing and slowly decreasing. It is then said to have a low and lazy heart rate. Blood pressure is low, with a small gap between systole and diastole. What treatment? Conservative treatment depends on the symptoms present. In the case of full-blown stenosis, a surgical procedure is performed, which consists in replacing the valve. Such a procedure should be performed before left ventricular failure occurs. photo: Shutterstock

This defect is considered a relative defect that develops as a result of right ventricular dilatation. Then, it may be associated with low blood pressure and those defects that overload the right ventricle, e.g. narrowing of the outlet of the pulmonary trunk, defect of the atrial or interventricular septum, narrowing of the left venous outlet. The essence of the defect is the backflow of blood during contraction from the right ventricle to the right atrium, which causes its expansion and hypertrophy. The right ventricle also expands and overgrows. As the pressure in the right atrium rises, this increase is transferred to the venous system. Symptoms of right ventricular failure develop. What symptoms? Patients complain of breathlessness during rest and exercise. There is a lack of appetite, nausea, a feeling of fullness in the abdomen and abdominal pain. Gastrointestinal symptoms are related to its hyperemia, liver enlargement or ascites. A characteristic symptom of the disease is excessive blood filling of the jugular veins with visible systolic ripple. There is also ripple in the liver. What treatment? Therapeutic management consists in combating the symptoms of circulatory failure and treating the underlying disease. Surgical treatment, which consists in replacing or plasticizing the valve, is also possible. Despite permanent disability, with a frugal lifestyle and adherence to medical recommendations, long-term survival is possible. photo: Shutterstock

This defect is a consequence of rheumatic disease. It causes an increase in pressure in the right atrium and its enlargement. Venous pressure increases, leading to generalized venous stasis in all tissues and organs. What symptoms? The dominant symptoms are those associated with right ventricular failure, i.e. hepatomegaly, edema, ascites. The significant widening and pulsation of the jugular veins is noteworthy. What treatment? Conservative treatment consists in treating heart failure. Surgical treatment is valve replacement. photo: Shutterstock