on the diagnosis and treatment of mitral stenosis（二尖瓣狭窄的诊断和治疗）.docVIP

On the diagnosis and treatment of mitral stenosis [Keywords] diagnosis and treatment of mitral stenosis [Etiology and pathogenesis] Mitral stenosis (mitral stenosis, MS) were rheumatic almost 2 / 3 of women, generally 10 years after acute rheumatic fever (at least 2 years) before any friction, usually 25 to 30 years of age at the onset of symptoms of congenital MS rare, the survival time of children less than 2 years old is not uncommon for patients with mitral stenosis. lesions, like the left atrial myxoma or thrombus formation rarely lead to MS. MS is a progressive damage of the disease, the degree of stenosis increases with age and gradually increased. Asymptomatic period of 10 to 20 years in most patients without rheumatic fever 10 years after onset of clinical symptoms of stenosis in the next 10 years, most patients can make the diagnosis of mitral stenosis, but patients are asymptomatic, normal mitral valve area is 4 ~ 6c m2, when the mitral valve narrowing to 1.5 ~ 2.5c m2, the only apparent hemodynamic the patient may feel tired when palpitations shortness of breath, this time the patient is generally 20 to 40 years. 10 years later, when the mitral valve narrowing to 1.1 ~ 1.5c m2, there will be obvious symptoms of left heart failure when the valve orifice less than 1.0c m2, the pulmonary artery pressure was significantly elevated, the patient developed right heart failure signs and symptoms, followed by repeated episodes of heart failure and death. [Clinical] 1 The main clinical manifestations of MS symptoms are dyspnea, hemoptysis, cough, palpitations, a small number of patients may have chest pain, syncope. Combined rapid atrial fibrillation, pulmonary infection, acute left ventricular failure can occur there chest pain, often Tip of coronary heart disease, severe aortic valve disease or pulmonary hypertension (caused by right ventricular ischemia), etc. syncope are rare, such as more prompt recurrent syncope with aortic stenosis, le