Valve leaflet thickening

Introduction About 36% of primary antiphospholipid antibody syndrome and 48% of antiphospholipid antibody syndrome with systemic lupus erythematosus have heart valve lesions: valvular lobular thickening, thrombotic neoplasm, mitral regurgitation and Narrow and so on. Valvular lobular thickening is mainly caused by heart valve disease. Heart valve disease is a heart disease in which the heart valve loses its one-way valve due to thickening, deformation, adhesion, calcification, and rupture. Heart valve disease can cause stenosis or insufficiency of the heart valve, so that the blood can not flow smoothly or flow backwards, the blood can not flow smoothly called the valve stenosis, the blood flow after the backflow is called valve insufficiency.

Cause

Valvular lobular thickening is mainly caused by heart valve disease. Heart valve disease is a heart disease in which the heart valve loses its one-way valve due to thickening, deformation, adhesion, calcification, and rupture. Heart valve disease can cause stenosis or insufficiency of the heart valve, so that the blood can not flow smoothly or flow backwards, the blood can not flow smoothly called the valve stenosis, the blood flow after the backflow is called valve insufficiency. The most common is mitral valve disease, followed by aortic valve disease.

Heart valve disease is a common heart disease in China, accounting for about 30% of heart surgery. The ratio of male to female is about 1:1.5. The causes include rheumatism, congenital, ischemic, infection and trauma. At present, valvular heart disease caused by rheumatism still accounts for the majority in China, but with the development of our society, the improvement of economic level, and the popularization of medical preventive measures. As well as aging, elderly degenerative valvular disease and ischemic valvular disease are increasing.

an examination

Related inspection

Heart sound map check ECG

The mitral valve consists of a anterior (large) flap and a posterior (small) flap. The tricuspid valve consists of three leaflets, anterior, posterior and septal. Both the aortic valve and the pulmonary artery are composed of three leaflets. The leaflets are meager, smooth, and elastic when they are normal.

Mitral stenosis: examination of the mitral face can be seen in the mitral valve face (), apical area can reach diastolic tremor, can be heard and diastolic, clearer, first heart sound hyperthyroidism, audible mitral valve Open slap sound; the second heart sound in the pulmonary valve area is hyperthyroidism, splitting, and sometimes the area can be heard and early diastolic murmur (Graham-Steell murmur).

X-ray examination: left atrial enlargement (right anterior oblique position swallowing fluoroscopy, visible esophageal indentation, pulmonary artery segment prominent, heart shadow is pear-shaped, hilar shadow increased, thickened.

Electrocardiogram examination: "P-wave of mitral valve" means that P wave is widened and concave; right ventricular hypertrophy with strain, common Pavl>1.0mV, RavR.0.5mV.

Mitral regurgitation: auscultation of the heart to the left; apical area can be heard and loud, rough systolic hairy murmur, often conduction to the underarm or back; can hear the third heart sound; pulmonary heart valve area second heart sound hyperthyroidism .

Imaging examination: (1) X-ray examination: left atrium, left ventricle enlargement, pulmonary artery segment prominent. (2) Electrocardiogram examination: left atrial enlargement and left ventricular hypertrophy and strain. (3) Echocardiography: When the left atrium of the left atrium is enlarged, the M-shaped map can be measured.

Aortic valve insufficiency: visual examination of pale face, auscultation of apex capture to the left and down, is lifted, the heart of the voiced sounds increased in the shape of a shoe, the aortic valve area and the left sternal border 3 to 4 intercostal can be heard Diastolic, high-pitched, descending-type snoring, conduction to the apex of the heart; apical area can be heard and low-pitched soft mid-diastolic murmur (Austin-Flint murmur); diastolic blood pressure decreased, pulse pressure increased, peripheral vascular signs, Such as water pulse, gunshot sound, capillary arrest and Durozicr sign.

Differential diagnosis

Valve thickening: Valve thickening is mainly caused by heart valve disease. Heart valve disease is a heart disease in which the heart valve loses its one-way valve due to thickening, deformation, adhesion, calcification, and rupture. Heart valve disease can cause stenosis or insufficiency of the heart valve, so that the blood can not flow smoothly or flow backwards, the blood can not flow smoothly called the valve stenosis, the blood flow after the backflow is called valve insufficiency. The most common is mitral valve disease, followed by aortic valve disease.

Heart valve disease: rheumatic Valvular disease is caused by recurrent rheumatic carditis, heart valve and its accessory structures (choscis, papillary muscle) lesions, resulting in valve dysfunction of valve stenosis and regurgitation, Hemodynamic disorders, that is, chronic rheumatic valvular disease, patients with heart valve damage often have a history of repeated rheumatic activity, but nearly 1/2 patients have no history of rheumatic fever and valvular heart disease. This disease is one of the common heart diseases in China, and it is more common in adults aged 20-40.

Antiphospholipid syndrome (APS) refers to serum anti-phospholipid antibody (APL)-positive, clinically having any symptoms of venous or arterial thrombosis, more than 3 habitual abortions, thrombocytopenia.

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