home Audience 5 Prolapsed heart valves – normal or pathological? We're talking to a pediatric cardiologist. Mitral valve prolapse in newborns Prolapse in children treatment

Prolapsed heart valves – normal or pathological? We're talking to a pediatric cardiologist. Mitral valve prolapse in newborns Prolapse in children treatment

Deflection of the atrium leaflet is not normal. In medicine, this pathology is called mitral valve prolapse. The disease occurs much more often in children than in adults. The danger of such a violation is that due to poor fit of the valves, there is a disruption in the movement of blood flow. As a result, blood partially flows from the ventricle into the atrium. in children, in most cases, it is a congenital disorder caused by an intrauterine abnormality in the development of internal organs.

From the school anatomy course

Heart disease occurs due to sagging of the valves separating the atrium and ventricles. At the moment of diastole (relaxation of the heart muscle), the valves should be closed. This is typical for normal myocardial function. During systole (contraction of the ventricles), the heart muscle contracts, which causes the valves to close. This prevents blood from flowing back from the ventricle into the atrium.

These two sections - the atrium and the left-sided ventricle are separated by the mitral valve. The latter includes two connecting doors. The mitral valve opens during diastole, allowing blood to move. The tricuspid valve is located nearby and lies between the atrium and the right ventricle.

What causes prolapse

This disease is considered very common among patients under the age of 12 years. Mitral valve prolapse in children can have many causes. Considering that most often this pathology is congenital in nature, functional changes could occur in the womb when the process of formation and development of fetal cardiac tissues was underway.

If we talk about the acquired form, then it is usually diagnosed in adolescents. In girls, the disease is confirmed much more often than in boys. In the presence of prolapse (sagging, deflection), the valve leaflets do not close tightly enough during myocardial contraction, which allows back blood to enter the atrium.

Disease in newborns

The occurrence of signs of mitral or tricuspid valve prolapse in a child of the first year of life is associated with one of the factors:

Features of intrauterine formation of the cardiovascular system.
Deformation of the valves, anomalies of their attachment.
Innervation disorders due to autonomic dysfunctions.

A disproportion in the size of the mitral ring, its expansion, or abnormal attachment of the leaflets to the heart wall is quite capable of causing mitral valve prolapse in a child 3 years of age and older. Such disorders relate to problems in the formation of connective tissue, which are inherited and manifest themselves in increased extensibility of the chords and valves. In this case, prolapse is not considered a defect requiring specific treatment. It is a feature of a growing organism that does not have dangerous or life-threatening consequences. The congenital form of the disease can be combined with vegetative-vascular dystonia and be expressed by similar symptoms.

Acquired form

Heart disease can provoke disorders of the autonomic system and cause psycho-emotional disorders. The development of the disease is often caused by injuries in the chest area. Rupture of the chord due to a strong mechanical shock leads to the valve being torn off and prevents the valves from fully adhering. In such cases, mitral valve prolapse in children and adolescents occurs with complications and requires immediate surgical treatment.

Often prolapse at an early age is provoked by rheumatic heart disease. The disease develops as a consequence of inflammation of the chords and valves against the background of tonsillitis, pneumonia, scarlet fever. Infectious and inflammatory diseases can affect the heart valves and cause an attack of rheumatism.

How does prolapse manifest?

The main symptoms of the disease include tachycardia, that is, rapid heartbeat. In a 6-year-old child with mitral valve prolapse, the heart rate may change for no apparent reason, and it is accompanied by anxiety, sweating, or shortness of breath. Children often complain of headaches that get worse in the evening and dizziness. In adolescents with prolapse, pre-fainting conditions occur, especially often during prolonged stay in a stuffy closed room.

Painful sensations in the chest area when the mitral valve sagging is also a characteristic symptom. The pain intensifies against the background of psychoemotional disorder and anxiety. Other symptoms of the disease include:

Panic attacks, fears.
Feeling short of air (hyperventilation symptom).
Attacks of suffocation due to excitement.
Nosebleeds.

The latter symptom is due to a decrease in the quality of blood clotting due to a lack of connective tissue fiber content.

Degrees of prolapse

By the amount of folding of the valves, you can get an idea of the severity of the disease. children may have:

First degree (leaf protrusion does not exceed 5 mm).
Second degree (deflection is 5-9 mm).
Third degree (the sashes bend by 9 mm or more).

Moreover, the degree of prolapse does not always correspond to the severity of the disease. To obtain a more informative picture of the pathology, it is important to study the volumes of returned blood during systole. Based on the length of the jet that enters the atrium, the degrees of prolapse are distinguished:

Zero. At this degree, mitral valve prolapse in children 11 years of age and earlier does not manifest any symptoms. Pathology can only be detected during ultrasound examination.
First. This degree of regurgitation also occurs latently. At this stage of the disease, the length of the stream barely reaches 1 cm.
Second. With prolapse of this degree, the length of the blood stream can reach 2 cm.
Third. This stage of the disease is characterized by a jet of more than 2 cm.
Fourth. The most severe degree, since the blood spreads over a large gap (more than 3 cm).

What examination do you need to undergo?

Today, the most convenient and informative way to recognize cardiac pathologies in children and adults is ultrasound (echocardiography) and electrocardiogram. Both methods provide specialists with the opportunity to determine the degree of sagging of the valves into the atrium and the length of the blood stream during reflux.

If the pediatrician hears a heart murmur in a child, he will refer the patient for diagnostic procedures. A characteristic click that occurs after the systolic phase may indicate protrusion of the valve into the atrium at the moment of compression of the ventricles. The clicks are clearly audible during exercise (deep inhalation and exhalation) and in a vertical position. Examination of children and listening to the work of the heart muscle serve as predetermining diagnostic methods.

For mitral valve prolapse, a child 7 years of age or older may be prescribed not only an ultrasound and ECG, but also additional diagnostic procedures:

Holter monitoring.
X-ray.
Catheterization.

How to treat pathology

Such babies who have congenital leaflet prolapse are registered with a cardiologist, but specific therapy is not prescribed to the child. In this case, the doctor may give recommendations for swimming and gentle physical exercise. Professional sports for children and adolescents with this diagnosis are usually prohibited.

Grade 1 mitral valve prolapse in a child does not require medication or any treatment procedures. To prevent the progression of the disease, parents need to constantly adjust the child’s psycho-emotional background with the help of sedatives and magnesium-containing drugs.

Drug therapy for stage 3 and 4 prolapse

The main goal of drug treatment is to improve the nutrition of the heart muscle, eliminate disorders and dysfunctions at the level of the autonomic nervous system. To improve myocardial contractility, the drugs Riboxin or Panangin are prescribed.

If the cause of acquired prolapse is one of the infectious diseases (for example, tonsillitis), the child is prescribed antibiotics. It is advisable to take the course of treatment under the supervision of medical staff in a hospital. You cannot self-medicate, otherwise parents expose their child to the risk of complications.

Physiotherapy

The condition of the heart muscle can be improved through a course of physiotherapeutic procedures. Several ways to treat mitral valve prolapse in children:

Electrophoresis using bromine and magnesium.
Spine massage.
Acupuncture.

In cases of severe valve prolapse, patients are recommended to undergo surgery to repair the valve or replace it completely. Such operations are performed both in Russia and abroad. The most popular country for the treatment of heart disease in children is Israel. This state has powerful material and technical equipment and qualified specialists.

Consequences of the disease and prognosis

Mitral valve prolapse in children can lead to serious health problems that cannot be eliminated without radical treatment. Severe complications that arise as a result of further sagging of the valves include rupture of the chord and the formation of adhesions that interfere with the operation of the valve.

An equally common consequence of the development of prolapse is its functional failure, which leads to shortness of breath, constant weakness and a feeling of fatigue. If the disease progresses rapidly, a decision is made to install an implant.

A rare complication of mitral valve prolapse in adolescence is infective endocarditis. With this disease, a person’s body temperature rises, blood pressure decreases, discomfort, malaise, joint pain occurs, and yellowness of the epidermis occurs.

In general, the prognosis for prolapse is favorable. As the child grows up, the condition of the heart muscle stabilizes, and there is no need for drug treatment.

Often, cardiologists refuse to consider first-degree valve pathology an independent disease. In children, mitral valve prolapse is characterized as a temporary disorder or borderline health condition that stabilizes with age. As a result of changes in constitutional characteristics, the disease goes away on its own in the majority of cases. So, for example, if a child was thin and tall, but subsequently gained the missing body weight, the valve can be restored. The prolapse will disappear without any kind of intervention.

What is important for parents to know

Intensive therapeutic and surgical treatment of mitral valve prolapse in children is resorted to in exceptional cases. Before starting to use medications, it is important to adjust the child’s lifestyle. Children in the first years of life, as a rule, do not experience a lack of physical activity, but as they grow older, children become more passive. This should not be allowed, because moderate physical activity helps strengthen the muscles and connective tissue of the heart valve, as well as the chord.

It is important to understand that debilitating loads are contraindicated for a child diagnosed with mitral valve prolapse. The best option is morning exercises for 15-20 minutes, playing in the fresh air, swimming in the pool. Cycling and skiing can also be useful.

In addition, parents should take care to create a favorable psychological atmosphere at home. The child should be comfortable in the family. Concord and harmony will help maintain calm, prevent psycho-emotional disorders and avoid a number of health problems.

Today, diseases of the cardiovascular system are detected during examination not only in the older generation, but also in children. The most common is mitral valve prolapse in children (MVP). What is the disease, what are its symptoms, and how is it treated? Let's figure it out.

MVP is a pathology of the heart; during operation of the organ, the mitral valve leaflets bend, and partial return of blood from the ventricle to the left atrium occurs. The greater its flow, the more severe the degree of the disease. When using a stethoscope, systolic clicks are heard, but sometimes there is no noise.

The disease was first discovered and symptoms described in 1887. But scientists did not know what the disease was associated with, why it occurred and how to treat it. They heard systolic clicks and a late heart murmur. Later, namely in 1963 and 1981, after research, answers to these questions were obtained. In 1979, the disease was given the name “prolapse,” and it is still used today.

In adolescents, MVP occurs in 2 - 15% of cases, in girls after 10 years - 2 times more often than boys. Prolapse is diagnosed even in infants; the average age of sick children is 6 - 15 years.

Depending on the origin, the following forms of PMC are distinguished:

Primary. The pathology is not so serious, but the consequences caused by it are significant and should not be ignored by doctors. Complications include arrhythmia, thromboembolism, mitral insufficiency (in adolescents it occurs due to damage to the chest).
Secondary. It manifests itself as a complication due to heart disease and accounts for up to 5% of all cases.

A valve with an anomaly allows more blood to pass through—the pathology is more complex. Based on the amount of valve prolapse, the following degrees are distinguished:

1st degree - deflection by 3 - 6 mm;
2nd degree – 6 – 9 mm;
Grade 3 – more than 9 mm.

Causes

Primary prolapse in children most often occurs due to disturbances in the growth (dysplasia) of connective tissues. Not only the valve itself changes, but also its structure, dimensions, and attachment. Zinc and magnesium deficiency, infectious diseases of pregnant women, metabolic disorders are the culprits of this condition.

There are many causes of secondary MVP in children. In the first place is heredity, most often transmitted from the mother, and also appears in the form of complications of such diseases: arrhythmia, rheumatism, endo- and myocarditis. In adolescents, the source of pathology can be chest injuries. Other congenital heart defects affect changes in the geodynamics of the left part. Vegetative-vascular dystonia, thyrotoxicosis, neuroses are common causes of the anomaly.

Manifestation

Typically, prolapse goes unnoticed and is detected only during a preventive examination. Doctors identify several symptoms of the disease:

Feeling of lack of air (sometimes you want to inhale as deeply as possible).
Headache at night and in the morning.
Fatigue, general weakness of the body.
The presence of pain and discomfort in the heart area.
Dizziness, fainting.
Sleep disturbance.

The main symptoms of MVP are systolic clicks, occurring alone or accompanied by murmurs. These sounds are heard when examining a child in a standing position or after physical activity (usually 20 squats).

If any of the symptoms occur, consult your pediatrician, cardiologist, or rheumatologist.

To diagnose pathology, an ECG is performed, an ultrasound of the heart area, an x-ray are prescribed, and blood is given for analysis. A set of examinations will reveal the inflammatory process. Additionally, phonocardiography is used, which makes it possible to analyze clicks, noises and “chordal squeaks” in the region of the heart.

Therapy

Treatment of children with prolapse is individual. Pay attention to the child’s age, gender, heredity, and signs of dysplasticity. The results of ultrasound, ECG and other examinations are compared.

Children with congenital MVP are not treated. Primary prolapse has a favorable prognosis. There are no restrictions on physical activity. Teenagers are not recommended to engage in professional sports; they should consult their doctor.

If a child exhibits symptoms of prolapse (insomnia, increased heart rate), doctors prescribe sedative herbal medicines. They will have a beneficial effect on the activity of the nervous system.

If a child with MVP suffers from shortness of breath, pain in the heart area, or general weakness during physical activity, the doctor will prescribe a more serious drug that normalizes heart function.

In case of secondary prolapse, which occurs as a result of past illnesses, the child should be hospitalized. Inflammation of the heart valves due to bacteria is treated with penicillin antibiotics. If the functioning of the organ is impaired or there is severe regurgitation, the rheumatologist will prescribe other drugs.

For any symptoms accompanying the disease, medications are taken only after consultation with a doctor.

In severe cases of rheumatic heart inflammation and valve insufficiency that cannot be treated with medication, surgical intervention is performed. The valve is replaced or replaced.

Prevention and prognosis

MVP in children usually occurs without any complications or symptoms. But maintenance therapy is necessary. Without it, valve insufficiency may develop and severe complications may arise in the future. These side effects only worsen the prognosis of the disease.

It is important to monitor the condition of a teenager with prolapse and carry out all therapeutic and preventive actions prescribed by the doctor.

Set of measures:

If the child has no complaints about his health, he should be examined by a cardiologist once every 2 years. If something bothers the baby, then an ECG and echocardiogram are performed every year.
Do not get involved in sports with a high load on the body. Avoid overwork.
Attend massage sessions, swimming pool. Such procedures have a beneficial effect on the cardiovascular system and general condition in general.
Providing your child with a nutritious and healthy diet high in magnesium.
If any of the symptoms of the disease appear, contact your doctor immediately.

Summary

A common ailment of the cardiac system in children, mitral valve prolapse, may be asymptomatic and do not require treatment. Without supportive therapy, prolapse can provoke other serious diseases in older age. Parents whose children have this pathology need to have information about treatment methods and methods of prevention. After all, it is mom and dad who are constantly with the child and will help prevent complications.

Mitral valve prolapse is a pathology in which the function of the valve located between the left ventricle of the heart and the left atrium is disrupted. In the presence of prolapse, during contraction of the left ventricle, one or both valve leaflets protrude and a reverse flow of blood occurs (the severity of the pathology depends on the magnitude of this reverse flow).

ICD-10	I34.1
ICD-9	394.0, 424.0
OMIM	157700
DiseasesDB	8303
MedlinePlus	000180
eMedicine	emerg/316
MeSH	D008945

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General information

The mitral valve is two connective tissue plates located between the atrium and ventricle of the left side of the heart. This valve:

prevents the reverse flow of blood (regurgitation) into the left atrium that occurs during contraction of the ventricles;
has an oval shape, the diameter ranges from 17 to 33 mm, and the longitudinal size ranges from 23 to 37 mm;
has anterior and posterior leaflets, while the anterior one is better developed (when the ventricle contracts, it bends towards the left venous ring and, together with the posterior leaflet, closes this ring, and when the ventricle relaxes, it closes the aortic opening, adjacent to the interventricular septum).

The posterior leaflet of the mitral valve is wider than the anterior one. Variations in the number and width of parts of the posterior valve are common - it can be divided into lateral, middle and medial folds (the longest is the middle part).

Variations in the location and number of chords are possible.

When the atrium contracts, the valve is open and blood flows into the ventricle at this moment. When the ventricle fills with blood, the valve closes, the ventricle contracts and pushes blood into the aorta.

When the heart muscle changes or in certain connective tissue pathologies, the structure of the mitral valve is disrupted, as a result of which, when the ventricle contracts, the valve leaflets bend into the cavity of the left atrium, allowing part of the blood entering the ventricle back.

The pathology was first described in 1887 by Cuffer and Borbillon as an auscultatory phenomenon (detected by listening to the heart), manifested in the form of mid-systolic clicks (clicks), which are not associated with the expulsion of blood.

In 1892, Griffith identified the association of apical late systolic murmur with mitral regurgitation.

It was possible to identify the cause of late murmur and systolic clicks only through angiographic examination of patients with the indicated sound symptoms (carried out in 1963-1968 by J. Barlow and colleagues). The specialists who carried out the examination found that with these symptoms, during left ventricular systole, a kind of sagging of the mitral valve leaflets into the cavity of the left atrium occurs. The identified combination of balloon-shaped deformation of the mitral valve leaflets with systolic murmur and clicks, which is accompanied by characteristic electrocardiographic manifestations, was designated by the authors as auscultatory-electrocardiographic syndrome. In the process of further research, this syndrome began to be called click syndrome, slamming valve syndrome, click and noise syndrome, Barlow syndrome, Engle syndrome, etc.

The most common term "mitral valve prolapse" was first used by J Criley.

Although it is generally accepted that mitral valve prolapse occurs most often in young people, data from the Framingham Study (the longest epidemiological study in the history of medicine, lasting 65 years) show that there is no significant difference in the occurrence of this disorder in people of different age groups and gender. . According to this study, this pathology occurs in 2.4% of people.

The frequency of detected prolapse in children is 2-16% (depending on the method of its detection). It is rarely observed in newborns; it is more often detected at 7-15 years of age. Up to 10 years of age, the pathology is equally often observed in children of both sexes, but after 10 years of age it is more often detected in girls (2:1).

In the presence of cardiac pathology in children, prolapse is detected in 10-23% of cases (high values are observed in hereditary connective tissue diseases).

It has been established that with a small return of blood (regurgitation), this most common valvular pathology of the heart does not manifest itself in any way, has a good prognosis and does not require treatment. With a significant amount of reverse blood flow, prolapse can be dangerous and requires surgical intervention, as some patients develop complications (heart failure, chordal rupture, infective endocarditis, thromboembolism with myxomatous changes in the mitral leaflets).

Forms

Mitral valve prolapse can be:

Primary. Associated with connective tissue weakness, which occurs with congenital connective tissue diseases and is often transmitted genetically. With this form of pathology, the mitral valve leaflets are stretched, and the retaining leaflets of the chord are lengthened. As a result of these violations, when the valve closes, the flaps protrude and cannot close tightly. Congenital prolapse in most cases does not affect the functioning of the heart, but is often combined with vegetative-vascular dystonia - the cause of symptoms that patients associate with heart pathology (periodically occurring functional pain in the chest, cardiac arrhythmias).
Secondary (acquired). Develops in various heart diseases that cause disruption of the structure of the valve leaflets or chords. In many cases, prolapse is provoked by rheumatic heart disease (an inflammatory disease of the connective tissue of an infectious-allergic nature), undifferentiated connective tissue dysplasia, Ehlers-Danlos and Marfan diseases (genetic diseases), etc. In the secondary form of mitral valve prolapse, pain that passes after taking nitroglycerin is observed, interruptions in heart function, shortness of breath after exercise and other symptoms. If the cardiac chords rupture as a result of a chest injury, emergency medical attention is required (the rupture is accompanied by a cough, during which foamy pink sputum is released).

Primary prolapse, depending on the presence/absence of noise during auscultation, is divided into:

The “silent” form, in which symptoms are absent or scanty, and noises and “clicks” typical for prolapse are not heard. Detected only by echocardiography.
Auscultatory form, which, when auscultated, is manifested by characteristic auscultatory and phonocardiographic “clicks” and noises.

Depending on the severity of the sagging of the valves, mitral valve prolapse is distinguished:

I degree - the doors bend by 3-6 mm;
II degree - there is a deflection of up to 9 mm;
III degree - the sashes bend by more than 9 mm.

The presence of regurgitation and the degree of its severity are taken into account separately:

I degree – regurgitation is mild;
II degree – moderately severe regurgitation is observed;
III degree - there is pronounced regurgitation;
IV degree – regurgitation is severe.

Reasons for development

The cause of protrusion (prolapse) of the mitral valve leaflets is myxomatous degeneration of valve structures and intracardiac nerve fibers.

The exact cause of myxomatous changes in the valve leaflets usually remains unrecognized, but since this pathology is often combined with hereditary connective tissue dysplasia (observed in Marfan syndrome, Ehlers-Danlos syndrome, thoracic malformations, etc.), it is assumed to be genetic.

Myxomatous changes are manifested by diffuse damage to the fibrous layer, destruction and fragmentation of collagen and elastic fibers, and increased accumulation of glycosaminoglycans (polysaccharides) in the extracellular matrix. In addition, type III collagen is detected in excess amounts in the valve leaflets during prolapse. In the presence of these factors, the density of the connective tissue decreases and the valves protrude when the ventricle is compressed.

Myxomatous degeneration increases with age, so the risk of mitral valve leaflet perforation and chordae rupture increases in people over 40 years of age.

Prolapse of the mitral valve leaflets can occur with functional phenomena:

regional impairment of contractility and relaxation of the left ventricular myocardium (lower basal hypokinesia, which is a forced decrease in range of motion);
abnormal contraction (inadequate contraction of the long axis of the left ventricle);
premature relaxation of the anterior wall of the left ventricle, etc.

Functional disorders are a consequence of inflammatory and degenerative changes (develop with myocarditis, asynchronism of excitation and conduction of impulses, heart rhythm disturbances, etc.), disorders of the autonomic innervation of subvalvular structures and psycho-emotional deviations.

In adolescents, the cause of left ventricular dysfunction may be impaired blood flow caused by fibromuscular dysplasia of the small coronary arteries and topographic abnormalities of the left circumflex artery.

Prolapse can occur against the background of electrolyte disorders, which are accompanied by interstitial magnesium deficiency (affects the production of defective collagen in the valve leaflets by fibroblasts and is characterized by severe clinical manifestations).

In most cases, the cause of valve prolapse is considered to be:

congenital connective tissue insufficiency of the mitral valve structures;
minor anatomical anomalies of the valve apparatus;
disorders of neurovegetative regulation of mitral valve function.

Primary prolapse is an independent hereditary syndrome that developed as a consequence of a congenital disorder of fibrillogenesis (the process of production of collagen fibers). Belongs to a group of isolated anomalies that develop against the background of congenital connective tissue disorders.

Secondary mitral valve prolapse is rare and occurs when:

Pathogenesis

The mitral valve leaflets are three-layer connective tissue formations that are attached to the fibromuscular ring and consist of:

fibrous layer (consists of dense collagen and continues continuously into the chordae tendineae);
spongy layer (consists of a small amount of collagen fibers and a large amount of proteoglycans, elastin and connective tissue cells (forms the anterior edges of the valve));
fibroelastic layer.

Normally, the mitral valve leaflets are thin, pliable structures that move freely under the influence of blood flowing through the opening of the mitral valve during diastole or under the influence of contraction of the mitral valve ring and papillary muscles during systole.

During diastole, the left atrioventricular valve opens and the aortic cone closes (preventing the flow of blood into the aorta), and during systole, the mitral valve leaflets close along the thickened part of the atrioventricular valve leaflets.

There are individual features of the structure of the mitral valve, which are associated with the diversity of the structure of the entire heart and are variants of the norm (narrow and long hearts are characterized by a simple design of the mitral valve, and short and wide ones are characterized by a complex one).

With a simple design, the fibrous ring is thin, with a small circumference (6-9 cm), there are 2-3 small valves and 2-3 papillary muscles, from which up to 10 chordae tendineae extend to the valves. The chordae hardly branch and are attached mainly to the edges of the valves.

The complex structure is characterized by a large circumference of the annulus fibrosus (about 15 cm), 4 to 5 leaflets and from 4 to 6 multicipital papillary muscles. The chordae tendineae (from 20 to 30) branch into many threads that are attached to the edge and body of the valves, as well as to the fibrous ring.

Morphological changes in mitral valve prolapse are manifested by the proliferation of the mucosal layer of the valve leaflet. Fibers of the mucosal layer penetrate the fibrous layer and disrupt its integrity (in this case, the segments of the valves located between the chords are affected). As a result, the valve leaflets sag and, during left ventricular systole, bend dome-shaped towards the left atrium.

Much less often, dome-shaped arching of the valves occurs with elongation of the chords or with a weak chordal apparatus.

With secondary prolapse, the most characteristic feature is local fibroelastic thickening of the lower surface of the arching valve and histological preservation of its internal layers.

Prolapse of the anterior leaflet of the mitral valve in both primary and secondary forms of pathology is less common than damage to the posterior leaflet.

Morphological changes in primary prolapse are a process of myxomatous degeneration of the mitral leaflets. Myxomatous degeneration has no signs of inflammation and is a genetically determined process of destruction and loss of the normal architecture of fibrillar collagen and elastic structures of connective tissue, which is accompanied by the accumulation of acidic mucopolysaccharides. The basis for the development of this degeneration is a hereditary biochemical defect in the synthesis of type III collagen, which leads to a decrease in the level of molecular organization of collagen fibers.

The fibrous layer is mainly affected - thinning and discontinuity are observed, simultaneous thickening of the loose spongy layer and a decrease in the mechanical strength of the valves.

In some cases, myxomatous degeneration is accompanied by stretching and rupture of the chordae tendineae, expansion of the mitral ring and aortic root, and damage to the aortic and tricuspid valves.

The contractile function of the left ventricle in the absence of mitral insufficiency does not change, but due to autonomic disorders, hyperkinetic cardiac syndrome may appear (heart sounds intensify, systolic ejection murmur is observed, distinct pulsation of the carotid arteries, moderate systolic hypertension).

In the presence of mitral regurgitation, myocardial contractility is reduced.

Primary mitral valve prolapse in 70% is accompanied by borderline pulmonary hypertension, which is suspected in the presence of pain in the right hypochondrium during prolonged running and playing sports. Occurs due to:

high vascular reactivity of the small circle;
hyperkinetic cardiac syndrome (causes relative pulmonary hypervolemia and impaired venous outflow from the pulmonary vessels).

There is also a tendency to physiological arterial hypotension.

The prognosis for borderline pulmonary hypertension is favorable, but in the presence of mitral regurgitation, borderline pulmonary hypertension can develop into high pulmonary hypertension.

Symptoms

Symptoms of mitral valve prolapse vary from minimal (in 20-40% of cases none at all) to significant. The severity of symptoms depends on the degree of connective tissue dysplasia of the heart, the presence of autonomic and neuropsychiatric abnormalities.

Markers of connective tissue dysplasia include:

Clinically, mitral valve prolapse in children can manifest itself:

Signs of dysplastic development of connective tissue structures of the ligamentous and musculoskeletal system revealed at an early age (includes hip dysplasia, umbilical and inguinal hernias).
Predisposition to colds (frequent sore throats, chronic tonsillitis).

In the absence of any subjective symptoms, nonspecific symptoms of neurocirculatory dystonia are detected in 20-60% of patients in 82-100% of cases.

The main clinical manifestations of mitral valve prolapse are:

Cardiac syndrome accompanied by vegetative manifestations (periods of pain in the heart area not associated with changes in the functioning of the heart, which occur during emotional stress, physical exertion, hypothermia and are similar in nature to angina pectoris).
Palpitations and interruptions in heart function (observed in 16-79% of cases). Subjectively, tachycardia (rapid heartbeat), “interruptions,” and “fading” are felt. Extrasystole and tachycardia are unstable and are caused by anxiety, physical activity, and drinking tea and coffee. Most often, sinus tachycardia, paroxysmal and non-paroxysmal supraventricular tachycardia, supraventricular and ventricular extrasystoles are detected; sinus tachycardia, parasystole, atrial fibrillation and flutter, and WPW syndrome are more rarely detected. Ventricular arrhythmias in most cases do not pose a threat to life.
Hyperventilation syndrome (disturbance in the respiratory regulation system).
Autonomic crises (panic attacks), which are paroxysmal states of non-epileptic nature and are distinguished by polymorphic autonomic disorders. They arise spontaneously or situationally and are not associated with a threat to life or severe physical stress.
Syncope (sudden short-term loss of consciousness accompanied by loss of muscle tone).
Thermoregulation disorders.

In 32–98% of patients, pain in the left side of the chest (cardialgia) not associated with damage to the arteries of the heart is observed. It occurs spontaneously, can be associated with overwork and stress, can be relieved by taking Valocordin, Corvalol, Validol, or goes away on its own. Presumably caused by dysfunction of the autonomic nervous system.

Clinical symptoms of mitral valve prolapse (nausea, feeling of a “lump in the throat”, increased sweating, syncope and crises) are more often observed in women.

In 51-76% of patients, periodically recurring attacks of headache are detected, which are similar in nature to tension-type headaches. Both halves of the head are affected, pain is provoked by weather changes and psychogenic factors. 11-51% experience migraine pain.

In most cases, there is no correlation between the observed shortness of breath, fatigue and weakness and the severity of hemodynamic disturbances and exercise tolerance. These symptoms are not associated with skeletal deformities (they are of psychoneurotic origin).

Dyspnea may be iatrogenic or associated with hyperventilation syndrome (there are no changes in the lungs).

In 20 - 28%, prolongation of the QT interval is observed. It is usually asymptomatic, but if mitral valve prolapse in children is accompanied by long QT syndrome and fainting, the likelihood of developing a life-threatening arrhythmia should be determined.

Auscultatory signs of mitral valve prolapse are:

isolated clicks (clicks), which are not associated with the ejection of blood from the left ventricle and are detected during mesosystole or late systole;
combination of clicks with late systolic murmur;
isolated late systolic murmurs;
holosystolic murmurs.

The origin of isolated systolic clicks is associated with excessive tension of the chords with maximum deflection of the mitral valve leaflets into the cavity of the left atrium and sudden bulging of the atrioventricular leaflets.

Clicks can:

be single and multiple;
listen continuously or transiently;
change its intensity when changing body position (increase in a vertical position and weaken or disappear in a lying position).

Clicks are usually heard at the apex of the heart or at the V point, in most cases they are not carried out beyond the borders of the heart, and their volume does not exceed the second heart sound.

In patients with mitral valve prolapse, the excretion of catecholamines (adrenaline and norepinephrine fractions) is increased, with peak increases observed during the day, and at night the production of catecholamines decreases.

Depressive states, senestopathies, hypochondriacal experiences, and an asthenic symptom complex (intolerance to bright light, loud sounds, increased distractibility) are often observed.

Mitral valve prolapse in pregnant women

Mitral valve prolapse is a common heart pathology that is detected during mandatory examination of pregnant women.

Mitral valve prolapse of the 1st degree during pregnancy proceeds favorably and can decrease, since during this period cardiac output increases and peripheral vascular resistance decreases. At the same time, heart rhythm disturbances (paroxysmal tachycardia, ventricular extrasystole) are more often detected in pregnant women. With prolapse of the 1st degree, childbirth occurs naturally.

In case of mitral valve prolapse with regurgitation and prolapse of the 2nd degree, the expectant mother should be observed during the entire period of pregnancy.

Drug treatment is carried out only in exceptional cases (moderate or severe with a high probability of arrhythmia and hemodynamic disturbances).

A woman with mitral valve prolapse during pregnancy is recommended to:

avoid prolonged exposure to heat or cold, do not stay in a stuffy room for a long time;
do not lead a sedentary lifestyle (prolonged sitting leads to stagnation of blood in the pelvis);
rest in a reclining position.

Diagnostics

Diagnosis of mitral valve prolapse includes:

Study of medical history and family history.
Auscultation (listening) of the heart, which allows you to detect a systolic click (click) and late systolic murmur. If the presence of systolic clicks is suspected, auscultation is performed in a standing position after slight physical activity (squats). In adult patients, an inhalation test of amyl nitrite is possible.
Echocardiography is the main diagnostic method that allows us to identify leaflet prolapse (only the parasternal longitudinal position is used, from which echocardiographic examination begins), the degree of regurgitation and the presence of myxomatous changes in the valve leaflets. In 10% of cases, it allows to detect mitral valve prolapse in patients who do not have subjective complaints and auscultatory signs of prolapse. A specific echocardiographic sign is sagging of the leaflet in the middle, end or throughout the entire systole into the cavity of the left atrium. The depth of the sagging is currently not particularly taken into account (its direct dependence on the presence or severity of the degree of regurgitation and the nature of the heart rhythm disturbance is absent). In our country, many doctors continue to rely on the 1980 classification, which divides mitral valve prolapse into degrees depending on the depth of prolapse.
Electrocardiography, which allows you to identify changes in the final part of the ventricular complex, disturbances in heart rhythm and conduction.
X-ray, which allows you to determine the presence of mitral regurgitation (in its absence, there is no expansion of the shadow of the heart and its individual chambers).
Phonocardiography, which documents the auscultated sound phenomena of mitral valve prolapse during auscultation (the graphic registration method does not replace the sensory perception of sound vibrations by the ear, therefore preference is given to auscultation). In some cases, phonocardiography is used to analyze the structure of phase indicators of systole.

Since isolated systolic clicks are not a specific auscultatory sign of mitral valve prolapse (observed with aneurysms of the interatrial or interventricular septa, tricuspid valve prolapse and pleuropericardial adhesions), differential diagnosis is necessary.

Late systolic clicks are better heard in the left lateral decubitus position and are amplified during the Valsalva maneuver. The nature of the systolic murmur during deep breathing may change; it is most clearly revealed after physical exertion in an upright position.

An isolated late systolic murmur is observed in approximately 15% of cases, heard at the apex of the heart and carried to the axillary region. It continues until the second tone, has a rough, “scraping” character, and is better defined by lying on the left side. It is not a pathognomonic sign of mitral valve prolapse (can be heard with obstructive lesions of the left ventricle).

The holosystolic murmur detected in some cases during primary prolapse is evidence of the presence of mitral regurgitation (carried out in the axillary region, occupies the entire systole and almost does not change with changes in body position, intensifies with the Valsalva maneuver).

Optional manifestations are “squeaks” caused by vibration of a section of the chords or leaflet (more often heard when systolic clicks are combined with noise than with isolated clicks).

Mitral valve prolapse in childhood and adolescence can be heard as a third sound during the phase of rapid filling of the left ventricle, but this tone has no diagnostic value (in thin children it can be heard in the absence of pathology).

Treatment

Treatment of mitral valve prolapse depends on the severity of the pathology.

Mitral valve prolapse of the 1st degree in the absence of subjective complaints does not require treatment. There are no restrictions on physical education, but professional sports are not recommended. Since grade 1 mitral valve prolapse with regurgitation does not cause pathological changes in blood circulation, in the presence of this degree of pathology only weightlifting and exercise on weight training equipment are contraindicated.

Grade 2 mitral valve prolapse may be accompanied by clinical manifestations, so symptomatic drug treatment may be used. Physical education and sports are allowed, but the optimal load is selected for the patient by a cardiologist during a consultation.

Mitral valve prolapse of the 2nd degree with regurgitation of the 2nd degree requires regular monitoring, and in the presence of signs of circulatory failure, arrhythmia and cases of syncope, individually selected treatment.

Mitral valve prolapse of the 3rd degree is manifested by serious changes in the structure of the heart (expansion of the cavity of the left atrium, thickening of the ventricular walls, the appearance of abnormal changes in the functioning of the circulatory system), which lead to mitral valve insufficiency and heart rhythm disturbances. This degree of pathology requires surgical intervention - suturing the valve leaflets or replacing it. Sports are contraindicated - instead of physical education, patients are recommended to perform special gymnastic exercises selected by a physical therapy doctor.

For symptomatic treatment, patients with mitral valve prolapse are prescribed the following drugs:

vitamins of group B, PP;
for tachycardia, beta-blockers (atenolol, propranolol, etc.), which eliminate rapid heartbeat and have a positive effect on collagen synthesis;
for clinical manifestations of vegetative-vascular dystonia - adaptogens (Eleutherococcus preparations, ginseng, etc.) and magnesium-containing preparations (Magne-B6, etc.).

During treatment, psychotherapy methods are also used to reduce emotional stress and eliminate the manifestation of symptoms of pathology. It is recommended to take soothing infusions (infusion of motherwort, valerian root, hawthorn).

For vegetative-dystonic disorders, acupuncture and water procedures are used.

All patients with mitral valve prolapse are recommended to:

give up alcohol and tobacco;
regularly, at least half an hour a day, engage in physical activity, limiting excessive physical activity;
maintain a sleep schedule.

Mitral valve prolapse detected in a child may disappear on its own with age.

Mitral valve prolapse and sports are compatible if the patient does not have:

episodes of loss of consciousness;
sudden and persistent disturbances in heart rhythm (determined using daily ECG monitoring);
mitral regurgitation (determined by the results of cardiac ultrasound with Doppler ultrasound);
reduced contractility of the heart (determined by ultrasound of the heart);
previous thromboembolism;
in the family history of cases of sudden death among relatives who had diagnosed mitral valve prolapse.

Suitability for military service in the presence of prolapse depends not on the degree of deflection of the valves, but on the functionality of the valve apparatus, that is, the amount of blood that the valve allows back into the left atrium. Young people are recruited into the army with grade 1-2 mitral valve prolapse without blood return or with grade 1 regurgitation. Military service is contraindicated in case of prolapse of the 2nd degree with regurgitation above the 2nd degree or in the presence of impaired conduction and arrhythmia.

Liqmed reminds you: the sooner you seek help from a specialist, the greater your chances of maintaining health and reducing the risk of complications.

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Mitral valve prolapse– one of the most common heart diseases. This pathology is characterized by insufficiency of the mitral valve functions. There are 3 degrees of severity of the disease, with the first degree being the least dangerous.

Typically, first-degree prolapse is asymptomatic, so it is discovered accidentally during an ultrasound of the heart. However, this disease requires regular medical supervision, as it can be aggravated by concomitant diseases and complications.

Mitral valve prolapse - what is it?

Mitral valve- This is a bicuspid septum located in the heart between the left atrium and the left ventricle. The name comes from the similarity of the valve with the headdress of a priest - the miter.

When blood flows from the left atrium into the ventricle, the valve opens. During further ejection of blood from the left ventricle into the aorta, the septal valves must be tightly closed. This is what normal system operation looks like.

In case of mitral valve prolapse, its doors sag and when closing there remains a hole between them. In this case, it is possible for some of the blood to flow back from the ventricle into the atrium. This condition is also called. Thus, a reduced volume of blood will enter the circulation, which will increase the load on the heart.

Depending on the size of the window in the septum, 3 degrees of the disease are differentiated:

1st degree is characterized by a hole of 3-6 mm and is the least dangerous;
The 2nd degree has a window of 6-9 mm;
The 3rd degree is the most pathological, the hole in the septum remains more than 9 mm.

The volume of blood that returns to the atrium from the ventricle is also taken into account to make the decision. This indicator is in this case a higher priority than the size of the prolapse.

Symptoms

In most cases, grade 1 mitral valve prolapse is almost asymptomatic. But in case of psycho-emotional stress, periodic pain in the heart area may occur.

In addition, in some patients this disease can cause the following abnormalities: opinions:

heart rhythm disturbances;
dizziness and prolonged headaches;
feeling of lack of air when inhaling;
cases of causeless loss of consciousness;
increase in body temperature to 37.2 0 C.

Quite often, such patients experience vegetative-vascular dystonia.

Diagnostics

Sometimes, if there is a heart murmur, sagging valve leaflets can be detected using a stethoscope. However, at the 1st stage of the disease, the volume of blood backflow into the left atrium may be insignificant and not cause noise effects. In this case, the prolapse cannot be determined by listening.
also, signs of prolapse are not always visible.
To accurately determine the presence of a disease Along with an ECG, it is necessary to perform an ultrasound of the heart. This study allows us to identify sagging of the mitral valve leaflets and its size.
Doppler study, additionally performed during ultrasound, allows you to determine the volume of regurgitation and the rate of return of blood to the atrium.
Sometimes x-rays are performed chest, which shows the sagging of the heart in case of illness.

To create a complete picture of the patient’s illness with MVP, the cardiologist also analyzes the following data:

history of the disease, features of the manifestation of symptoms;
history of chronic diseases of the patient throughout his life;
presence of cases of this disease in the patient’s relatives;
general blood and urine tests;
blood biochemistry.

Reasons for appearance

There are two types of mitral valve dysfunction:

Treatment

In the absence of symptoms, a patient with grade 1 MVP with minimal regurgitation does not require treatment. Most often, this category includes children who are diagnosed with this disease during a cardiac ultrasound examination during medical examination. Usually they can even play sports without restrictions. However, it is necessary to periodically be observed by a cardiologist and monitor the dynamics.

Medical assistance may be needed only if this prolapse is accompanied by dangerous symptoms, such as heart pain, heart rhythm disturbances, loss of consciousness and others. In this case, treatment is aimed at eliminating symptoms. There is no surgical treatment for grade 1 MVP.

Medicines

Depending on the negative manifestations accompanying mitral valve prolapse, the following medications are prescribed:

In addition, the patient needs physical therapy, breathing exercises, spa treatment, massage, relaxation and psychotherapeutic sessions.

You should also adhere to a healthy lifestyle, proper nutrition and moderate exercise.

Folk remedies

Traditional medicine, along with pharmaceutical drugs, give good results in eliminating the symptoms of MVP of the 1st degree.

In this case, the following medications are used that have a sedative effect and strengthen the heart muscle:

a decoction of horsetail, which helps strengthen the heart muscle and at the same time is a good sedative;
tea from a mixture of the following herbs: motherwort, hawthorn, mint and valerian, which has a powerful calming effect;
tea made from a mixture of heather, sloe, motherwort and hawthorn, which is also very calming;
Rosehip decoction as a source of vitamin C, necessary for the heart muscle.
a mixture of 20 eggshells, juice from 20 lemons and honey in the same volume as eggs and juice.

You should also eat dried fruits, red grapes and walnuts, as they contain large amounts of potassium, magnesium and vitamin C.

It should be borne in mind that in some cases, mitral valve sagging may increase with age, so patients with grade 1 prolapse, even in the absence of symptoms, require regular monitoring by a cardiologist (1-2 times a year).

What is the danger of the disease, complications

In the case of congenital MVP of the 1st degree, complications occur very rarely. More often they occur as a secondary form of the disease. Especially if it occurs due to injuries in the chest area or against the background of other heart diseases.

The following consequences of the disease occur:

Mitral valve insufficiency, in which the valve is practically not held in place by the muscles at all, its flaps dangle freely and do not perform their functions at all. As a result of this disease, pulmonary edema occurs.
Arrhythmia characterized by abnormal heart rhythm.
Infective endocarditis– inflammation of the inner wall of the heart and valves. Due to loose closure of the valve, after an infection, mainly sore throat, bacteria from the bloodstream can enter the heart. This disease causes severe heart defects.
Transition of the 1st degree of the disease to stages 2, 3 or 4 as a result of further sagging of the mitral valve leaflets and, as a consequence, a significant increase in the volume of regurgitation.
Sudden cardiac death. Occurs in very rare cases as a result of sudden ventricular fibrillation.

Women expecting a child need to be especially careful about this disease. Basically, stage 1 MVP during pregnancy does not pose a threat to the woman or the unborn child.

At the same time, 70-80% of pregnant women may experience attacks of tachycardia and arrhythmia. The likelihood of gestosis, premature rupture of amniotic fluid, shortened delivery times and decreased labor activity also increases.

Prognosis for the disease

With grade 1 mitral valve prolapse, the prognosis for life is almost always positive. Basically, this disease is almost asymptomatic or with minor symptoms, so the quality of life is not particularly affected. Complications develop very rarely.

Sports activities with MVP of the 1st degree are allowed with almost no restrictions. However, power sports should be excluded, as well as jumping and some types of wrestling associated with strong blows.

Also excluded are extreme sports where athletes experience pressure changes, such as:

diving;
diving;
Skydiving.

The same restrictions apply to the choice of profession. A person with this disease cannot work as a pilot, diver or astronaut.

It should be noted that with mitral valve prolapse of the 1st degree, the young man is recognized as fit for conscription for military service.

Prevention

In order to exclude the transition of PMC of the 1st degree to more serious stages disease, as well as the development of serious complications, prevention of this disease should be observed. Preventive measures are especially necessary for acquired prolapse. They are aimed at the maximum possible cure of diseases that cause mitral valve prolapse.
All patients with grade 1 MVP should it is necessary to be regularly observed by a cardiologist, to monitor the dynamics of indicators of the size of prolapse and the volume of regurgitation. These actions will help to promptly detect the onset of complications and take the necessary measures to prevent them.
In addition, it is very important to give up bad habits as much as possible., exercise regularly, sleep at least 8 hours a day, eat right, minimize the impact of stress. By leading a healthy lifestyle, a person practically eliminates the appearance of an acquired form of the disease and significantly increases the chances that symptoms of primary MVP will not appear.

Thus, grade 1 mitral valve prolapse is a fairly serious disease that should be regularly monitored by a doctor. However, with timely adherence to therapeutic and preventive measures, it is possible to minimize the symptoms and complications of the disease.

In order for the blood circulation of the pumping system of the heart to always occur in the right direction, there is a valve apparatus inside the atria and aorta that regulates blood flow. The valves open and close so that blood flow is directed only in one direction, avoiding reverse flow. As soon as the atria pass blood to the aorta, they close, preventing flow into the original cavity. Mitral valve prolapse of the 1st degree provokes circulatory disorders.

To understand the cause of this pathology, you need to know what the mitral valve is. This is part of the access device, which consists of flaps. If they begin to sag or sag towards the atrium, then the pathology is called mitral valve prolapse, or MVP for short.

As a result of the sagging of the valves during the period of cardiac contraction, the blood leaving the atria partially returns back into their cavity. This problem is not dangerous or fatal, but due to impaired blood circulation, infectious pathogens can quickly land on the valve apparatus, causing serious inflammatory processes. Also, MV prolapse contributes to arrhythmic disorders.

If a person has retrograde blood flow, it is called regurgitation. As a rule, sagging of the valve leaflets by less than 3 mm does not allow blood to return back into the cavity of the left atrium.

There are two types of MV prolapse:

Primary or congenital;
Acquired.

If the pathology develops against the background of previous heart diseases (myocarditis, endocarditis, heart attack, defects), then it is classified as a secondary type. The congenital type of prolapse occurs in 30-40% of people who do not feel any disorders in the cardiovascular system at all. In most cases, congenital pathologies cause virtually no heart problems.

Mitral valve prolapse with 1st degree regurgitation: how to determine?

Retrograde blood flow allows the classification of MVP. To determine the degree of sagging of the valve flaps, the amount of blood that fills the left ventricle is assessed. Most often, patients experience mitral valve prolapse with grade 1 regurgitation. That is, the valves sag towards the atria by 3-6 mm, but no more. In this case, reverse circulation does not cause significant disturbances in blood flow and patients do not experience unpleasant symptoms of the disease.

It is generally accepted that with grade 1 prolapse of the mitral valve, a person’s health condition is normal. Usually the problem is detected during random diagnostic procedures. No treatment is prescribed for the pathology, but regular visits to a cardiologist are mandatory.

Many patients are interested in whether it is possible to play sports when mitral valve prolapse with weak retrograde flow is detected. Doctors say that moderate physical activity is not contraindicated, but rather necessary. Recommended sports activities include:

But even with 1st degree of MVP, it is strictly forbidden to engage in weightlifting and use strength training equipment.

As for more serious pathologies, prolapse, which causes the valves to bend up to 9 mm into the atria, is classified as the second degree of pathology. In this case, drug treatment is used, and physical activity should be selected by a cardiologist.

Grade 3 MVP is characterized by sagging of more than 9 mm. This pathology leads to the development of serious changes in the structure of the heart muscle. Often, third-degree prolapse causes mitral valve insufficiency and severe arrhythmias. To eliminate the problem, it is necessary to perform an operation - suturing the valves or prosthetic valve apparatus. After surgery, the doctor can select therapeutic exercises.

Diagnosis of 1st degree mitral valve prolapse: how to recognize?

Basically, MVP can be diagnosed based on the first complaints that the patient describes. But, since the first two degrees are practically asymptomatic, the pathology is detected by chance. With more serious sagging of the valve leaflets, people experience the following symptoms:

The diagnosis of grade 1 mitral valve prolapse is made after undergoing tests such as listening to the heartbeat with a stethoscope. But if the regurgitation is mild, the doctor will not be able to detect a heart murmur. In such cases, the patient is referred for echocardiography with Doppler examination. The diagnostic procedure allows you to see the condition of the valves and the reverse flow of blood into the atrium. There is no point in undergoing an ECG, because it does not reveal any changes.

MVP of the 1st degree in a child: main signs and causes of development

Symptoms of the disease at a young age can vary. Some babies do not experience heart failure at all. In other cases, the pathology has a pronounced course.

Grade 1 MVP in a child may be accompanied by the following manifestations:

Chest pain;
Increased heart rate;
Fast fatiguability;
Changes in mood;
Short-term fainting states.

Chest pain occurs in approximately 30% of adolescent patients. Typically, such phenomena are associated with tense chords, physical/emotional stress, and oxygen deprivation.

Fatigue occurs in adolescents who do little physical activity. As a rule, this symptom is characteristic of those children who sit at the monitor for a long time or give preference to mental activity. During physical education lessons they experience shortness of breath due to poor preparation.

It is not uncommon for children with MVP to suffer from neuropsychological signs. They complain of nervous breakdowns, mood swings, nervousness, irritability, tearfulness, and aggression. If a child experiences emotional stress, he may faint.

MV prolapse often develops as a result of magnesium deficiency. This problem contributes to the disruption of collagen production. Also, magnesium deficiency has a bad effect on the functioning of all tissues of the body and blood supply. Children experience electrolyte imbalance. It is important to note that a child with MVP is characterized by low weight, inappropriate for his height. Many children are diagnosed with scoliosis, loss of appetite, flat feet, underdeveloped muscles, myopathies, etc.

Prolapse of the anterior leaflet of the mitral valve: treatment in children and adults

If MVP is accompanied by severe symptoms, then they can be eliminated with the help of selected therapy. In some cases, it is possible to remove the signs of pathology, in others, to reduce their severity. Treatment is prescribed individually, taking into account the characteristics of the body, age, gender, and genetic factors.

The choice of drugs depends on the severity of the clinical course of the disease. Typically, patients of different ages are prescribed the following groups of medications:

Sedatives – if the symptoms are affected by a disorder of the autonomic nervous system;
Beta blockers – helping to restore heart rhythm;
Nutritious – to improve myocardial function;
Anticoagulants – preventing the formation of blood clots in the atria.

But the main importance is adjusting the patient’s lifestyle. First of all, the degree of mental stress is normalized, which must be combined with physical exercise. To accurately adjust sports activities, you need to go to physical therapy, where an experienced specialist will select the best gymnastics complex for an individual. It's good to go to the pool for swimming.

In childhood, it is important to ensure that the child does not overexert himself nervously and mentally, as this will aggravate the pathology and cause chronic fatigue. To do this, parents need to adjust their study, work and rest schedules. From time to time, children are sent to sanatoriums, where they will receive specialized massages, mud treatment, acupuncture, etc.

For some patients, it is advisable to use herbal medicine. Doctors may recommend sedative herbal remedies - motherwort, St. John's wort, sage. Horsetail and ginseng are also used.

Medicines that may be prescribed include:

Also, for metabolic disorders, various physiotherapeutic procedures are used, which are selected on an individual basis. Surgical intervention is indicated only for the last degree of MVP.

In childhood, patients with mitral valve prolapse should be registered with a cardiologist. They should see a specialist every six months in order to promptly detect worsening pathology and promptly begin effective treatment. Physical exercises can be performed by almost all children, but with grades 2 and 3 of the disease they must be reduced, and in severe cases they must be limited.