The tricuspid valve can not close completely tricuspid incompetence_ general knowledge

The tricuspid valve can not close completely tricuspid incompetence_ general knowledge
Summary
The tricuspid valve can not be closed completely (tricuspid incompetence) It is given much trouble in leaf that rare, and expanded by artery high pressure of lung and tricuspid valve moring causes. Common at prominent bicuspid valve pathological change and chronic lung worry. Heart systolic phase close, cause blood flow into right room to be more rare than tricuspid stenosis instead because of tricuspid valve right room severely.
Cause of disease
1,It is to cause the right ventricle to expand under high pressure by the lung artery that the functional tricuspid valve can not close completely the most common cause of disease, the tricuspid valve ring is expanded, lead to the fact the tricuspid valve can not be relatively closed completely and own structure of valve is normal. Such as rheumatism the intersection of bicuspid valve and disease, inborn cardiovascular disease ' A narrow, ends a dose of syndrome of door full of trees of lung artery) The intersection of lung and worry,etc..
2,It is not completely rare that the organic tricuspid valve is closed. Inborn the intersection of Ebstein and deformity, membrane due to inflammation valve damage and tricuspid valve prolapse in the infective heart, membrane myocardium fiber, atrium dextrum mucus tumour in wind worry, a kind of cancer syndrome, coronary heart disease, heart, after right ventricle myocardial infarction and chest traumatism.
Pathologic physiology The systolic pressure of the right room is only 1/4 of the systolic pressure of left room, so equal intensity can not be closed completely, against flow than to against little and a lot of flow have, it compensates issue to be relatively long bicuspid valve tricuspid valve. It is not complete not to accompany the artery high pressure of lung and organic tricuspid valve of high pressure of systolic phase of right room to close, it is relatively small against flow, it is difficult to cause extravasated blood and right heart of the systemic circulation to be depleted. Continue and send and can not shut off completely in the relativity tricuspid valve of the artery high pressure of lung, because the right room is pressed and increased notably, even exceed the systolic pressure of left room, against flow being very big, dynamics of blood flow changes obviously, it is apt to cause extravasated blood and right heart of the systemic circulation to be depleted.
Clinical manifestation
(1) Symptom When the tricuspid valve is closed and does not amalgamate artery high pressure of lung completely, can present the heart and arrange reducing and symptom of systemic circulation extravasated blood of blood volume. The tricuspid valve is closed and does not amalgamate the disease patient of bicuspid valve completely, symptom of lung extravasated blood can be lightened because the tricuspid valve close the development not complete, but right heart depleted behavior such as weak, abdominal distension, edema, the intersection of liver and district pain, arrange blood volume with other heart reduced symptom can further in weight.
(2) Physical sign Main physical sign is The whole systolic phase lofty tone of left bottom flange of brestbone, drying one kind of noises, the noise can be strengthened behind inhaling and oppressing the liver; But if the depleted right ventricle can't increase the heartbeat amount noise difficult to strengthen. Only when the flow is very large, one kind of noises that the third heart sound and very brief low-key relaxation of the tricuspid valve district roar in middle period. Intravenous pulse wave picture v wave (are also called the reflux wave, while shrinking for the right ventricle, the blood flows back to due to right room systemic vein) of neck Increase; Can lay one's hand on and liver beat. When the valve prolapses, can hear in the tricuspid valve district and not the injection loudspeaker sound of click. Its physical sign of extravasated blood is depleted and the same as the right heart.
Laboratory and other inspections
(1) X-ray examination can be seen the right ventricle, atrium dextrum and increase. The right room presses the persons who rise, it is obvious the azygos vein is expanded and thorax product liquid; The person who has ascites, lift on the diaphragm. Can see right room systolic phase beats while perspecting.
(2) The electrocardiogram can show the right room plumply to strain while checking, the right room is loose; And often there is not complete right bunch that props up block and atrium and quivers.
(3) Pursue to check and can be seen the right ventricle, atrium dextrum to increase in the supersound aroused in interest, upper and lower vena cavas are increased widely and beating; One kind of tricuspid valves of flail. Two-dimentional supersound aroused in interest to pursue to prove backflow in acoustics radiography, Doppler checks and can be judged against procedure degree and lung artery high pressure in supersound.
(4) The heart conduit checks and determines left ventricle and right ventricle heartbeat amount ratio with the radiography, estimate and examine it against the procedure degree. Smaller than 1.0ing has backflow of tricuspid valve.
Differential diagnosis
Bicuspid valve close completely systolic phase, district of apex of the heart, dry kinds of noise, the armpit travel left, weaken while inhaling. The first sound of apex of the heart district is weakened. The heart circle leaves and expands left, the apex of the heart district touches limitation systolic phase and praises kind beats, the left ventricle is plump and expanding. When artery high pressure of lung and right heart are depleted, there can be intravenous anger one of neck, liver is swelling, edema of lower extremities. The supersound aroused in interest is pursued and can be diagnosed clearly
[1]' >Next page
|