73慢性风湿性心瓣膜病（73 chronic rheumatic valvular heart disease）.doc

73慢性风湿性心瓣膜病（73 chronic rheumatic valvular heart disease） Fifth chronic rheumatic valvular heart disease (Rheumatic, Valvular, Disease) Rheumatic valvular disease due to repeated rheumatic attack, the occurrence of heart valve and its appendages (chordae and papillary muscle) lesions, leading to valvular stenosis and insufficiency of valvular dysfunction, produce hemodynamic disturbance, is a chronic rheumatic valvular disease, heart valve injury patients often have recurrent rheumatic activity history however, nearly 1 / 2 of the patients without a clear history of rheumatic fever and heart disease. This disease is one of the common heart diseases in our country, which is more common in 20-40 year old adults. Rheumatic valvular heart disease is the most common of two types of valves, followed by aortic valves, which are often associated with mitral valve lesions, known as combined valvular disease. The causes of mitral valve and aortic valve invasion may be related to the pressure overload. The main cause of valve dysfunction is rheumatic fever, but it can also be caused by non rheumatic. mitral stenosis Pathology Recurrent rheumatic mitral valve endocarditis caused by membrane fusion between leaflet and tendon adhesion, thickening, calcification that leaflet chordae shortening, and can also be stuck, the valve flap stiff stenosis, according to the degree of lesion can be divided into diaphragm type and funnel type. First, the diaphragm type main body lesions are mild, tendon lesions are not obvious, soft leaves, but also free movement, and can be divided into three subtypes. (1) adhesion at the junction of the leaflets and lobes makes the orifice narrow and fibrous thickening at the margin. (two) the thickening of the valve, in addition to the junction adhesion, the valve itself has varying degrees of thickening, affecting its mobility, may be accompanied by mild closure of incomplete. (three) in addition to the valve lesion, the diaphragm funnel has the adhesion a