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PostSubject: heart valves   Thu Oct 06, 2011 5:43 pm

Heart valves .. heart valves





Introduction to the subject ..



Suffers a significant number of patients of different heart valve diseases. These diseases, and different causes or types, they almost all share certain symptoms and signs, make it easier for the doctor diagnosed and suspected presence of the help of some specific tests

This in our article, which will be divided into two parts, we'll show first and as an integral function of the heart valves and the role in this function. Hence, we will talk briefly about diseases in general and valves types and causes and symptoms, and also we will look to ways to diagnose and treat, especially the role of surgery in this treatment. And Snassehb Finally, in Part II of the article about the role of prosthetic valves in the treatment of these diseases and how to evaluate job performance and the complications that may result from the imbalance in this performance.



Heart is a hollow member of a small, slightly larger than the size of a fist, is located in the middle of the rib cage with a simple AC to the left side of the cage. The heart is divided into two halves, separated by a barrier, not allowed under normal circumstances, the passage of blood between the two halves. And divided each of the halves to Tjovin or two rooms: a room known Baloven high and lower chamber known Battin. Separates each atrium and ventricle valve, and separates each ventricle and the related artery valve. These valves, in their natural state, that the blood passes in one direction when it opens, and prevents reflux of blood or when converting from which closes the valves are known scientifically Bdezamat and the four heart valves are:
1 - mitral valve (also known as mitral valve) and separates the left atrium and left ventricle and allowed in the normal passage of blood in one direction from the atrium to the ventricle.
2 - aortic valve (also known as aortic valve) is located between the left ventricle and the aorta (also known as aortic artery), which allows the passage of blood at the opening of a one-way from the left ventricle to the aorta.
3 - tricuspid valve: located between the right atrium and right ventricle, and allows the passage of blood in one direction from the right atrium to right ventricle.
4 - pulmonary valve: located between the right ventricle and pulmonary artery, and allows the passage of blood in one direction from the right ventricle to the pulmonary artery and ultimately into the lungs.
And opens both the mitral and tricuspid valve when the heart in diastole when the valve closes both the aortic and pulmonary valve to allow for Btinin to receive the blood. And opens each of the aortic valve and the pulmonary valve during systole, while the closing of both mitral and tricuspid valve to allow blood to pass through them to all of the aorta and the pulmonary artery and the succession.
The right atrium receives blood returning from all magistrates top and bottom of the body, Muftqr loader for oxygen and carbon dioxide, by and large know Wreden upper cava vein and inferior vena cava. The blood passes from the right atrium to right ventricle through the valve separation between the tricuspid and pumped right ventricle blood constriction of the heart through the pulmonary valve into the pulmonary artery and ultimately into the lungs where it purifies the carbon dioxide and carries oxygen to come back again, during the four pulmonary veins to the left atrium, and from it, and through the mitral valve into the left ventricle. When the contraction of the heart again, push the left ventricle the blood through the aortic valve to the aorta and thus the distribution of blood to various parts of the body through the branches of the aorta the many, bringing in oxygen and food necessary to return once again loaded with carbon dioxide to the right side of the heart , and so is repeated each of the blood circulation and the pulmonary circulation, respectively.
The creation of Almighty God that heart so effectively a small ability to respond to the changing needs of the body who shall always pump more blood when the individual's effort greater, and less blood is pumped when eternity to rest, such as sleeping, for example.
Than stated above, it is clear Malsamamat of great importance in the work of the heart as a whole, since they control the rush of blood through the heart of it, is working to empty the heart chambers are fully in one direction and prevents reflux of blood to the rooms vacated for that reason, and that any damage or malfunction of these valves affect the function of the heart vary varying degree of unity of the defect.


Causes of disease heart valves ..
The most important diseases that affect the efficiency and functioning of the valves are:
1 - rheumatic heart disease, a disease Asyib valves as a result of the vulnerability of one of rheumatic fever in childhood and in early age.
2 - disease, ischemic heart disease due to hardening of the coronary arteries feeding the heart muscle of the heart. And usually affects the patients' advanced age.
3 - changes that may occur in the valves due to aging, which tends to be the result of calcium deposits and hardening them, valves and more susceptible to these changes is the aortic valve.
4 - valves affected by inflammatory bacterial infection due to direct acute or chronic.
5 - Some diseases that affect other body tissues, Kmufasl for example, may affect the heart valves or lining membrane.
6 - Some diseases of the connective tissue of the body may affect the form and function of the valves, such as what is happening in the presence of Marfan's disease.

These are all reasons why, but acquired, the person may be born a congenital defect in one of these valves, and is usually severe constriction or even complete blockage in it. Requires surgical intervention in the first days or months of age.
Whatever the type of disease affecting the valve, it infects Baltadhaq valve either as a result of his inability to open freely or reflux (also known as Gap or smuggling) as a result of inability to closure. The two conditions are met together in the same valve or may be affected more than one valve and at the same patient in any case, or both. And impede the narrowing of the valve of the flow of blood between the atrium and ventricle, or between ventricle and artery related to it. In the case of reflux valve, the blood seeps through the Riqath others capable of closing the arbitrator to the heart chamber that is supposed to be cleared from the blood are filled in part of the new and the amount of blood the same Dchth out! This amount will vary depending on the vulnerability of the valve disease. The heart compensates this imbalance in the work of the valves sold to work even more extra effort, either to accommodate the excess flow of blood reflux in the case of the apostate or to overcome a narrow valve he needs to pump blood from the body. If the situation continues as it is for a long time, the enlarged heart gradually and usually end up being to congestive heart failure. The mitral valve more susceptible to damage, followed by the aortic valve.



Symptoms and signs of heart valve diseases ..




Result in heart valve disease symptoms vary according to the affected valve and the extent of progress of the disease. Recall of the following symptoms:
1 - shortness of breath, especially when you do physical effort.
2 - chest pain, also speaking when you do physical effort.
3 - dizziness, fainting, dizziness, or even in advanced cases. And these are also usually associated with narrow valve disease, especially aortic valve stenosis.
4 - Fatigue and lethargy.
5 - heart palpitations.
6 - a cough that may be accompanied by blood, especially in cases of mitral valve disease.
7 - congestion of the liver and swelling of the ankles.
The patient did not feel any of these symptoms mentioned above in the simple cases, or medium. The doctor can infer the quality of disease and examine the patient to listen to heart sounds with a stethoscope and to ensure the presence of murmurs or more companion or not.



Diagnosis of diseases of the heart valves:


Plays a patient's medical history (also known as clinical curriculum) and complaining of symptoms that, in addition to clinical examination a large role, either in the presence of suspected disease or in the diagnosis and diagnosis of complications. The doctor asked some of the tests or diagnostic tests to confirm the presence of the disease and determine the extent of progress, including:
1 - Chest x-rays, and help to assess the size of the heart and Hgrath, also help to determine the impact of the disease on the lungs.
2 - ECG (also known as fee ECG) and helps to diagnose disorders in a heartbeat, if any, will also give an impression of enlarged heart chambers. It is also possible, by ECG inference of a lack of coronary arteries, if any.
3 - heart imaging ultrasound (known as ultrasound), either through the rib cage or through the perspective of the esophagus. This is the way the diagnostic method of choice for diagnosis as it can see the movement of valves and registration closed, and make sure the arbitrator. Or not and estimate the percentage of stenosis or reflux and record the movement of blood within the heart and from the major arteries and to measure the inflation of various heart chambers and evaluating the work of the heart muscle.
4 - has forced the doctor, in rare cases, to perform diagnostic cardiac catheterization to confirm the presence of the disease in the valves. However, cardiac catheterization is necessary to depict the coronary arteries of the heart in patients after a certain age to make sure they are free of stenosis, which may require surgery during the reform process of the valve or change.


Treatment of diseases of the heart valves ..


Can heart valve patient, under constant medical supervision, to live many years and the use of appropriate medications and prescribed by the doctor depending on the type of the disease. But in cases of advanced disease or in the absence of the feasibility of these drugs, it becomes necessary to conduct the intervention, either by catheter medical treatment (and offer an example of the expansion valve or a narrowed coronary narrowed pulmonary valve by the balloon) or by surgery.
Working surgeon usually hard to maintain the valve natural fix, especially in cases of mitral or aortic, if the state of the valve permit Fausah via a scalpel particularly if Mtadhaqa or repair of Riqath or tendons that support it, or places the ring around him to help him Segregation tightly in cases of vomiting, but often to no alternative for the surgeon to perform the switching of the valve, are valve lift damaged and replaced valve replacement, prosthetic valves, are many and varied, but overall is divided into valves alternative metal valves alternative tissue of human or animal origin.
And specifies the type of valve replaced a lot of health and social considerations. We will talk at length in Part II of this article is about the different prosthetic valves, and these factors determine the choice. As we will talk about ways to follow up the functionality of these valves and alternative medicines that the patient must be addressed, and ways to diagnose bugs in its functionality and complications that may result from this imbalance.

Important additions for the subject matter ..



Because the heart is a pump it is possible to weaken its effectiveness, leading to become a heart rate faster or slower than normal, may occur in some cases, the sick heart muscle itself can not do that to contract efficiently and should be a so-called "cardiomyopathy" Cardiomyopatly .

Valve problems
The work of the heart valves is one of the small mechanical issues, where it opens to allow the passage of blood and then closes to prevent re-entry back again, if increased thickness of the balconies, they lose their natural elasticity.


How can he know that the patient's heart at risk?


The main symptoms of heart disease is chest pain, difficulty breathing, swelling of the ankles and palpitations, but must determine the nature of chest pain resulting from heart disease, as well as the amount of shortness of breath, which is considered normal and when it is swollen ankle natural and What is the nature of the flickering which occurs as a result of the disease in the heart for the pain Paz chest muscle blood vessels feeding the heart and needs of oxygen through the coronary arteries, these arteries may narrow or block leads to the denial part of the heart muscle fed by the artery of the patient access to adequate nutrition, blood then the patient feels pain in his chest.
If fed a coronary artery may be able to feed the heart muscle by enough blood at rest, but during the effort to become the amount of blood is insufficient and therefore the patient feels that in good condition at rest, but if it exceeds his effort a certain limit begins to feel pain in the chest and the medical term So is "angina."

The patient often feels as if his chest angina had surrounded the compressor belt may extend to the neck pain and sometimes to the jaw or gums, may be affected by the right or left arm pain the patient may feel pain in the chest from the back or front.


How to differentiate the patient the pain of heart disease and pain other diseases? In other times is not chest pain associated with heart disease and the patient feels this pain like a stab knife, usually in the left side of the chest that may extend to the left arm, but it never reaches to the neck or jaw, has come the pain after the effort and will last for half an hour or for hours even though the patient may have rested, and may be this type of pain associated with emotion and usually go away the pain quickly once to confirm the doctor to the patient that his heart healthy.
The result is chest pain due to diseases other than heart and in this case the pain is completely different, the most common diseases are "inflammatory crystal" any inflammation of the lung cavity, which covers the lungs and lines the chest wall from the inside and produces inflammation crystal habit as a result of lung infection, pneumonia or sometimes because of a blood clot in the lung disease pulmonary embolism and pain caused by inflammation of both sides of a crystal chest and rarely affects the two sides together and usually affects the patient's cough, which increases the intensity of pain.
And chest pain may be caused by diseases of the esophagus and sometimes it is difficult to distinguish between pain caused by heart disease and that resulting from the disease in the esophagus, is often the basis of the problem is to drink the contents of the stomach and she comes back to the esophagus.


What is Heart murmurs?
Vibrations is short voice heard during the course of the blood in the various valves, or through the arteries due to factors satisfactory or heart disease is the heart, may also be due to physiological factors do not carry any meaning.
We can understand that perception pump pumping liquid in the tube equal diameter at an appropriate speed, the fluid is moving without having to make a sound, it goes in one direction and quickly equal in various depths of the tube, but if narrowed tube or expanded in part, or increased speed of the liquid increase large currents that arise from the lateral vibrations cause sound can be recorded, or is it the roar can be heard in the ear, which is known Ballguet.
Do ado heart disease?
Confusion resulting from the lack of mitral, which occurs when the flow of blood from the left atrium into the left ventricle, and also the confusion resulting from the narrow aortic valve, and occurs when contraction of the left ventricle to push blood into the aorta, can be designated disease, doctors often call ado located in the heart of children, ado-Hamid, and often causes a child's fears of medical examination, which cause rapid heartbeat, and an increase in the speed of blood flow in arteries, causing side currents give rise to vibrations of sound.
The speed of blood flow in children property physiological unsatisfactory, even with the absence of fear, and other features of this confusion Hamid happen in the first period of contraction of the heart, and his palace, and smoothness, unlike the confusion of patients, which is characterized by its length and body-, and felt by hand as well to hear in ear.




Last Update fuse problems ..
German medical revolution: a new technique for the installation of heart valves without surgery for children ..




In the process leading up to the birth of new types of heart surgery, it is possible to revolutionize medical big in this sensitive area, and then increase chances of success, it will be possible in Germany, installation of new valves of the heart in young boys and girls without the need for surgery.
Said Felix Berger, director of the hospital of birth defects of the heart in Berlin Professor, the German Institute of Cardiology in Berlin, was first used surgical method to evaluate the heart valves defective moral, which have been approved recently at the level of all Germany in the treatment of one of these defects with the girl in the sixteen years of age.
According the newspaper, "Middle East", the surgeons in this new way of installing this new pulmonary valve by passing a catheter from the groin to the heart after doctors were unable to install this valve only by opening the chest .. But the disadvantage of this method is the high price, with an estimated cost of more than twenty thousand euros.
Felix Berger added that it is expected that the Institute conducts three surgeries other similar soon.

A new technique for the treatment of heart valves
In the same context, Dr. Magdi Yacoub, the famous Egyptian heart surgeon for its intention to cooperate with Dr. Ahmed Zewail, Nobel Prize winner for science, research work for the new heart valves using the technique of nanotechnology.
He noted that the research will be conducted within a comprehensive project plan for it to establish a cooperative framework on large medical heart disease in the Arab world in collaboration with the Universities of Oxford and Imperial, and Florence and the Library of Alexandria and the Magdi Yacoub Institute, London.
He added that the project actually began the unity of research in Alexandria will be followed by other units in the cities of Egyptian, Arab, and in which to work, doctors and scientists from different parts of the world, is currently studying a disease of high inflation in the heart muscle, which occurs as a result of mutations that genetic and hereditary, and lead to sudden death and complications serious, noting that can be installed to prevent this death.
According to Dr. Jacob also being doing research on the type of anti-microbe Alvaksenat Alsobha childhood rheumatic fever, to suit the type of Gas located in Egypt.


Valves from stem cells
The Swiss scientists have been able for the first time the development of the human heart valves by a "stem cells", which opens later to fix many of the defects in the human heart.
They say that to achieve the development of such valves in the laboratory, during pregnancy, a way that implanted in the body of the infant after birth, will enable the human one day replace the components of the heart, in some cases, even before birth.
The scientists added that this technological revolution, medical applied to children and adults, may benefit from the return valves are more effective than those that are extracted from the bodies of the deceased or the other manufacturer.
It is noteworthy that heart failure means the inability to pump blood to the arteries and back to the common causes of fatty deposits on artery walls.


Open-heart surgery without anesthetic
City Hospital, enabling physicians Chennai, the capital of Tamilnadu in south India to perform open-heart surgery and was described as "unique" to a girl at the age of 16 years, the fact that her heart is located on the right, without general anesthetic.
The news agency, "Yu said any" medical sources at the hospital the government city of Chennai, saying: "It has been successfully for the first time in India, a process of replacing the mitral valve heart in the right side of a girl at the age of 16 years, noting that a team of specialists, surgery open-heart led Professor Viswakumar head of cardiac surgery at the hospital conducted the operation, which lasted about two hours. "
The sources pointed out that the girl was suffering bouts of shortness of breath and fatigue constant over the past four years, noting that the severity of these seizures have increased significantly in the last six months.
The sources added that the girl was also suffering from arthritis, as well as problems in the lungs and chronic inflammation Balqbbat wind and a persistent cough and inflammation of the sinus.
For his part, said Professor Viswakumar: "It is because of the complex situation in the condition of the girl it was not possible given sedated years, so we have been conducting the process in an innovative way," asserting that the operation succeeded completely, and that a girl has in no excellent health but it is still under health surveillance.



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We ask Allah for good health for all ..



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