The diagnosis of tricuspid stenosis and _'s symptom of the differential diagnosis

The diagnosis of tricuspid stenosis and _'s symptom of the differential diagnosis
Tricuspid stenosis (tricuspidstenosis) Rare on clinic, and the most for rheumatism membrane inflammation in the heart one and then offer as a gift and damage, often amalgamate a pathological change of bicuspid valve or aorta, simple tricuspid stenosis is rare. See more women, the overwhelming majority is caused by rheumatic fever, but rheumatism single tricuspid stenosis is extremely rare. As sequela of rheumatic fever, it is similar to mitral stenosis that pathology is changed, namely valve fiber take, increase thick, edge have superfluous living beings grow, three the intersection of valve and mutual adhesion or merge, form the narrow holes of triangle. Pathological change can also prolong and chorde tendinae and papilla skin. But intensity and range of tricuspid valve pathological change are lighter than bicuspid valve, it is rare to merge under the valve, and seldom there is calcium that is deposited. Narrow after taking shape, the obstacle happens when the blood flow flows into the right ventricle from the atrium dextrum, therefore the atrium dextrum is expanded, the pressure rises. Because of the reflux blockage of vena cava, venous pressure is raised for a long time, signs such as intravenous anger one of neck, hepatomegaly, ascites and four limbs edema,etc. appear. The right ventricle withers because of reducing in blood flow volume. When with bicuspid valve pathological change, the right ventricle is very plump.
Expand according to typical noise, atrium dextrum and symptom and physical sign of systemic circulation extravasated blood, can generally make diagnosis, the feasible right heart conduit inspection of the person who has difficulty on diagnosing, if the tricuspid valve steps difference of a diastolic pressure in 0.27kPa( 2mmHg) equally The above, can diagnose as tricuspid stenosis.
The differentiation of this disease and other important diseases is as follows:
1,Atrium dextrum mucus tumour, when blocking a hole in tumour, can also cause the clinical manifestation of tricuspid stenosis, but the medical history is short, the course of disease develops fast, pursue to have the unique vaporific picture of cloud in the supersound aroused in interest, can be distinguished.
2,The main symptom of tricuspid stenosis is caused by gastrointestinal tract and stagnation of the blood of liver spleen, such as discomfort, losing the appetite, indigestion and abdominal distension in the liver district,etc.. With weak and four limbs edema sometimes. Simple tricuspid stenosis, there are many and non- obvious heart and lungs symptoms, with the patient of the mitral stenosis, also because right ventricle blood flow volume is reduced, heart and lungs symptom is lighter than simple mitral stenosis person.
3,Physical examination visual surface cheek slight cyanosis and jaundice ' The stagnation of the blood of chronic liver causes) . The intravenous anger one of neck, even beat. Hepatomegaly, the quality is relatively hard, touch a tender spot, can lay one's hand on to beat before systolic phase sometimes. The person who has ascites, the belly swells, there are voiced sounds of mobility. When the heart is checked, the heart voiced sound circle expands to the right side. The first sound of tricuspid valve district is hyperfunction, can pat and hit the sound open after the second sound. Can hear a cylinder and one kind of noises of relaxation before systolic phase among the 4th rib of left reason of brestbone, can touch and tremble sometimes. While inhaling deeply, because thorax negative pressure increases, the blood flow volume of atrium dextrum increases, the noise is obviously strengthened, can distinguish with the mitral stenosis.
|