[Science Popularization Officer of the Tenth Hospital] Mitral valve prolapse is a health alarm

The news that Da S died suddenly due to influenza and pneumonia is heartbreaking! According to media reports, Da S had a history of mitral valve prolapse for many years and had been hospitalized many times. In 2018, she fainted and was sent to the hospital because she had not recovered from a cold for a long time. Patients with mitral valve prolapse have poor resistance. After a cold, if they are infected with bacteria, especially hemolytic streptococci, their heart disease symptoms will be aggravated and even life-threatening. Some experts have suggested that influenza, pneumonia, mitral valve prolapse, and low immunity are multiple factors that led to Da S's worsening condition and death.

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What exactly is mitral valve prolapse?

The human heart is like a house with four doors - valves. The mitral valve is a double-opening one-way door connecting the left atrium and the left ventricle. The valve is composed of the valve ring, valve leaflets, chordae tendineae and papillary muscles. Any abnormality in any of these structures will lead to valve dysfunction.

When the heart contracts and the valve closes, the leaflets lie flat on the same horizontal plane, which can effectively ensure tightness during closure and prevent blood from flowing back. However, factors such as congenital maldevelopment or acquired pathology can cause the leaflets of the mitral valve to lengthen and relax, the chordae tendineae to lengthen or break, and the papillary muscles to be insufficiency or break. When closing, the leaflets bulge inward and fall into the left atrium, and the structure of the valve ring becomes concave and cannot be closed tightly. This is "mitral valve prolapse", a type of structural heart disease with an adult incidence of about 5%.

Who is prone to mitral valve prolapse?

First of all, from the perspective of age and gender, young women are the most susceptible group, among which primary mitral valve prolapse is more common, and the cause is currently unknown. In addition, the mitral valve tissue of the elderly is prone to aging and relaxation, which can easily induce mitral valve prolapse.

Secondly, people with underlying diseases are more likely to have mitral valve prolapse, such as:

(1) Marfan syndrome is a dominant hereditary connective tissue disease. Most patients have multiple heart malformations such as mitral valve prolapse.

(2) People suffering from rheumatic autoimmune diseases, such as systemic lupus erythematosus, polyarteritis nodosa, ankylosing spondylitis and other connective tissue diseases.

(3) Patients with pectus excavatum, which is also a congenital developmental malformation characterized by the sternum being sunken backwards and inwards, often accompanied by mitral valve prolapse.

(4) People with coronary heart disease, cardiomyopathy, myocardial infarction, hyperthyroidism, infective endocarditis and other diseases are prone to secondary mitral valve prolapse.

(5) People with low immunity are prone to myocardial infection, which may induce secondary mitral valve prolapse.

How to detect mitral valve prolapse ?

First, observe whether there are any symptoms. Generally speaking, patients with mitral valve prolapse often feel palpitations and fatigue in the early stage; the more typical symptoms are dull pain in the chest area, palpitations, cerebral ischemic attack, syncope, etc.; accompanied by symptoms may include shortness of breath, dizziness, vertigo, and some are accompanied by migraine. Here is a reminder that if you have these symptoms, you should be alert to the disease.

Secondly, physical examination findings. General heart auscultation, electrocardiogram, chest X-ray or chest CT may indicate abnormalities, and the gold standard for diagnosing the disease is echocardiography, which can directly observe the structure and function of the heart, including the position, shape and movement of the mitral valve. Through real-time imaging, doctors can see the dynamic changes of the mitral valve during heart contraction and relaxation, thereby determining whether prolapse exists. Patients with the above symptoms are recommended to undergo echocardiography as soon as possible to rule out the disease.

How is mitral valve prolapse treated?

Asymptomatic patients generally do not need treatment, but regular check-ups and follow-ups are required. For patients with symptoms, the primary disease causing mitral valve prolapse should be actively treated. The main treatment methods are:

(1) Surgical treatment: valve repair or replacement.

(2) Interventional treatment: transcatheter mitral valve edge-to-edge repair, transcatheter mitral valve annuloplasty, transcatheter mitral valve replacement, etc.

(3) Mitral valve prolapse combined with other acute symptoms should be treated symptomatically, such as syncope, transient ischemic attack, etc.

The specific treatment method varies from person to person. It is recommended to consult a professional doctor to obtain a treatment plan that suits you.

What are the daily precautions for patients?

For patients with mitral valve prolapse, daily health care and protection are very important.

1. Prevent cold infections

This is especially important!!! Many patients with mitral valve prolapse have poor body resistance and should take precautions to prevent colds, especially in the cold autumn and winter. They should strengthen cold prevention and keep warm to reduce cold stimulation. Such people should get the flu vaccine as soon as possible, which will have a preventive effect on the occurrence of flu.

Pay attention to oral hygiene and prevent infections, especially upper respiratory tract infections and gingivitis caused by common hemolytic streptococcal infections. Infection by this bacteria can cause local inflammation, local cell necrosis and adhesion, leading to mild valve stenosis to severe stenosis, aggravating the symptoms of mitral valve prolapse.

2. Properly arrange rest and activities

The severity of symptoms varies, so rest and activities should be arranged reasonably according to the actual situation. Those with serious conditions should stay in bed, while those in relatively good physical condition can engage in appropriate activities, but they must also be careful not to overwork themselves after the activities.

3. Strengthen protection against heart failure

Many patients with mitral valve prolapse will have varying degrees of chest tightness, shortness of breath, fatigue and other symptoms of heart failure. They should actively prevent and treat heart failure to reduce the greater harm caused to patients by acute attacks of heart failure.

4. Prevent blood clots

Patients with mitral valve prolapse should not sit cross-legged or squat for a long time. They should also change their positions frequently and maintain limb function, which is good for preventing lower extremity venous thrombosis. Patients with mitral valve prolapse and atrial fibrillation should also take some anti-thrombotic drugs. If symptoms such as speech difficulties and limited limb movement occur, it indicates that cerebral stroke may occur, and medical treatment should be sought as soon as possible.

5. Eat right and relax

Try to eat a light diet, eat more fresh vegetables and fruits, and stay away from spicy, greasy, and irritating foods. Maintain a relaxed and happy mental state, visit the hospital regularly, and adjust the treatment plan in time according to changes in the condition.