mitral zadap prolapse

mitral volve prolapse (emm. vhee. pii.) haah eka volvular hriday rog aahe jyache vaishishtya systole darmyan davya alindat asamanyapane jaad jhalelya mitral volve patrakadvare visthapan hote. haah zadapchya mixomates degenerationcha prathamik prakar aahe. emm. vhee. pii. chey vividh prakar aahet, jeey vyapakpane abhijat aanee abhijat nasalele mhanoon vargikrut kele jaatat. classic emm. vhee. pii. chya gambhir prakarananmadhye, guntaguntinmadhye mitral regergitation, sansargjanya endocarditis, congestive haart failuer aanee durmil paristhitit, hrudayavikaracha zatka yancha samavesh hoto.
emm. vhee. pii. chey nidan echocardiographiver avalambun asate, jeey mitral zadap drishyaman karnyasathi ultrasoundcha vapar karate.
emm. vhee. pii. hii sarvat samanya volvular vikrutee aahe aanee loksankhyechya 2-3% varr parinam karnyacha andaj aahe aanee 40 paiki 1 lokanna tee asoo shakate.
yaa sthitiche varnan pahilyanda 1966 madhye johnn brereton barlo yanni kele hote. tyanantar jeey. yanni yala 'mitral walve prolapse' asey naav dile. michael crilly. jaree madhya-systolic click (prolapsing mitral patrak aavaj) aanee systolic kurkur 1887 madhye stethoscopes doctor emm. cuffer aanee emm. barbillan.
chinhe aanee lakshane.
kinchali.
mitral volve prolapse asalelya vyaktiche auscultation jhalyavar, madhya-systolic click, tyanantar varchya bajula ushira systolic kurkur aikoo yene samanya aahe. kurkuritpanachi lambi mhanje rakt davya alindat parat galat asalela kalavadhi, jyala punarujjivan mhanatat. sampoorn systolemadhye systolemadhye kurkuris hooloo-systolic kurkur mhanatat. jaree samanyatah qamee punarujjivanshi sambandhit asale taree, madhya teey usheera systolic asalela kurkur ajunahi lakshaniy hemodynamic parinamanshi sambandhit asoo shakato.
itar bahutek hrudaypudyanchya kurkurinchya ulat, mitral walve prolapscha kurkur ubha rahoon aanee valsalva yuktine (purvichya systolic click aanee lamb kurkur) tivra hoto aanee basanyane (nantar systolic click aanee lahan kurkur) qamee hoto. hypertrophic cardiomyopathycha kurkur haah yaa paddhatiche anusaran karnara hrudayatil dusra ekach kurkur aahe. emm. vhee. pii. chee kurkur hypertrophic cardiomyopathy kurkurit aavajapasun madhya-systolic klikchya upasthitine vegali karata yete, jeey emm. vhee. pii. chey aksharshah nidan karate. haat pakadanyachya yuktivadamule emm. vhee. pii. chee kurkur aanee hypertrophic cardiomyopathy kurkur qamee hote. haat pakadanyachya yuktivadamule kurkur karnyacha kalavadhi dekhil qamee hoto aanee madhya-systolic klikchya veles vilamb hoto.
valsalvachi yukti aanee ubhe rahane yaa donhimule hrudayatil shirancha paratava qamee hoto, jyamule davya ventricular diastolic bharane (preload) qamee hote aanee corde tendinivar adhik shithilata yete. yamule systolemadhye mitral zadap lavkar pasaru shakate, jyamule aadhi systolic click (i.eae. ess 1 chya jawal), aanee eka lamb kurkur.
mitral walve prolapse syndrome.
aitihasikdrushtya, mitral walve prolapse syndrome hii sandnya dhaddhadane, asamanya purv-yadruchchik vedna, vyayamachya velee dyspania, qamee boddy maas index aanee electrocardiogram vikrutinshi (ventricular tachycardia) sambandhit emm. vhee. pii. varr lagoo kelee gelee aahe, syncope, qamee raktadab, dokedukhi, dokedukhi, vyayam asahishnuta, jatharantratil vyatyay, sardiche toke aanee swayatt majjasansthechi karyakshamta (dysotonomia) darshavinari itar chinhe.
mitral regergitation.
mitral volve prolapse haah varanvar saumya mitral regergitationshi sambandhit asato, jithe systole darmyan davya nilayatoon davya alindat rakt aniyamitpane vahate. americet, emm. vhee. pii. heey gambhir, gair-ischemic mitral regergitation sarvat samanya kaaran aahe. heey adhunmadhun mitral zadpala aadhar yogdan corde tendinichya futanyamule hote.
emm. vhee. pii. punarujjivan tivrateche praman samanyatah shrenikaran pranalimadhye andajit kele jaateh
hrudayatil atalata.
mitral volve prolapse asalelya lokanmadhye erythmic mitral volve prolapse asoo shakato jyamadhye samanya loksankhyechya tulanet ventricular sankuchan vikar aanee tachycardiachya uchch ghatanancha samavesh asato, jaree donhi ghatananmadhil sambandh purnapane spasht nahee. donhi mitral patrakancha prasar aanee mitral regergitation upasthiti yamule shramachya darmyan gambhir ventricular erythmiacha dhoka aanakhi vadhato, jyache shastrakriyetun nirakaran kele jaau shakat nahee. sarvat samanya taal vikar mhanje ventricular extracistol, tyanantar paroxismal alind tachycardia.
achanak hrudayavikaracha mrutyu.
gambhir mitral volve prolapse aanee madhyam teey gambhir mitral regergitation aanee qamee jhalela dawa nilayatil ejection ansh haah erythmia aanee alind fibrillationshi sambandhit aahe joou hrudayavikarachya zatkyat aanee achanak hrudayavikarachya mrutyushi (ess. see. dii.) vadhu shakato. yaa erythmiamadhye prolapsney yogdan dile aahe yacha konatahi purava naslyamule, yaa guntagunt mitral regergitation kinwa congestive haart failuermule asoo shakatat. emm. vhee. pii. asalelya samanya loksankhyemadhye jivghenya erythmia praman qamee rahate. hrudayavikarachya achanak jhalelya mrutyumule darvarshi 0.20 teey 0.40 takke rugna hotat.
jokhim ghatak.
ehlers-danloss syndrome, marphan syndrome kinwa polycystic kidney rog asalelya vyaktinmadhye emm. vhee. pii. adhik varanvartesaha houu shakate. itar jokhamichya ghatakanmadhye kabaricha rog aanee pectus exkevetamsarkhya chhatichya bhintitil vikrutincha samavesh hoto. adnyat karananmule, emm. vhee. pii. rugnancha boddy maas index (bii. emm. aay.) qamee asato aanee teey samanyatah emm. vhee. pii. nasalelya vyaktinpeksha dubale asatat. striyanmadhye dekhil sandhe hypermobility asate.
sandhivat taap haah jagbharat samanya aahe aanee hriday zadap kharab honyachya anek prakaranansathi jababdar aahe. dirghakalin sandhivatacha hriday rog haah tantumay sankalpasah varanvar honari jaljal darshavito. zadpatil mukhya sharirik badalanmadhye patrake jaad hone, kamisural fusion aanee snayu dorkhand lahan karane aanee jaad karane yancha samavesh hoto. qamee matrechya pratijaivikanchi dekhbhal naan kelyas sandhivat tapachi punaravrutti tulanene samanya aahe, visheshtah pahilya prakarnanantarchya pahilya teen teey paach varshant. hrudayachi guntagunt dirghakalin aanee gambhir asoo shakate, visheshtah jarr zadap samavisht asel tarr. strape ghashasathi niyamit penicillinchya sevanachya aagmananantar sandhivat taap vikasit deshanmadhye qamee samanya jhaala aahe. junya pidhimadhye aanee bahutek qamee vikasit jagaat, upchar kelelya sandhivatachya tapamule volvular rog (mitral walve prolapse, volvular endocarditischya swarupat punarsankraman aanee volve futane yasah) hii eka samasya kayam aahe.
2004 teey 2005 darmyan bharatiy rugnalayat, 24 paiki 4 endocarditis rugna abhijat vanaspati darshavanyat ayashasvi tharale. sarvanna sandhivatacha hrudayavikar (aar. etch. dii.) hota aanee tyanna dirghkal taap aala hota. yaa sarvanmadhye gambhir vilakshan mitral regergitation (emm. aar.) hote. (ekala gambhir mahadhamani punarutthan (aii. aar.) dekhil hote.) ekat flail postariyar mitral patrak (pii. emm. ell.) hote.
mitral zadap, jyala bishapchya metershee samya asalyamule asey naav denyat aale aahe, too hriday zadap aahe joou davya nilayatoon hrudayachya davya alindat raktacha backflow rokhato. tyat done paaney asatat, eka agrabhag aanee eka prushthbhag, jee davya nilayala aakunchan yete tevha bund hotat.
pratyek patrak uutinchya teen tharanni banalele asateh 'atrialis', 'fibrosa' aanee 'spongiosa'. classic mitral walve prolapse asalelya rugnanmadhye atirikt sanyojak ootee asatat jyaa spongiosa jaad karatat aanee fibrosamadhye kolejanache bundle vegale karatat. glycosaminoglycane, dermaton sulfetchya atirekitemule heey hote. yamule patrake aanee lagatchya uutinna kamkuvat karate, parinami patrakache kshetrafal vadhate aanee corde tendinichi vaadh hote. corde tendinichya vadhanyamule anekada futate, samanyatah mageel patrakala jodalelya cordela. pragat jakhama-jyat samanyatah prushthbhagachya patrakacha dekhil samavesh asato-tyamule patrake dumadatat, ulatat aanee davya karnakakade visthapan hote.
nidanat.
gambhir, erythmic mitral volve prolapschya nidanatil samanya jokhim ghatakanmadhye khaleel goshtincha samavesh hotoh
anuvanshiki.
mitral walve prolapse heey anuvanshikdrushtya vijatiy autosomal pramukh vaishishtya aahe, jeey eka palkankadun eka mulamadhye hastantarit kele jaau shakate, jyala utparivartit januk varshane milanyachi 50 takke shakyata asel.
sanshodhanat emm. vhee. pii. aanee prathamik siliya dosh yanchyatil sambandh disun aala aahe. abhyasanni zink finger prathine disip 1 janukatil utparivartan olakhale aahe jeey siliogenesische niyaman karate; teech samasya undaranmadhye aadhalali jyanni yaa janukasah emm. vhee. pii. vikasit kele. asey aadhalun aale qee vikasadarmyan prathamik siliyachya hanimule pragatishil mixomates degeneration aanee sakhol mitral walve pathology hote.
mitral zadapche mixomates degeneration hii eka anuvanshik vikrutee aahe jee xq28 janukamadhye mapp kelee jaate.
emm. vhee. pii. shhee sambandhit asalelya itar janukanmadhye khaleel goshtincha samavesh aaheh
emm. vhee. pii. chee anuvanshik karane guntaguntichi aahet aanee sadhya purnapane samajali jaat naheet. emm. vhee. pii. chya vikasat guntaleli serve januke aanee anuvanshik yantrana purnapane olakhanyasathi pudhil sanshodhan aavashyak aahe.
nidan.
echocardiography hii prolapsed mitral walveche nidan karanyachi sarvat upayukt paddhat aahe. dvimiteey aanee trimiteey echocardiography visheshtah maulyavan aahe kaaran tee mitral annulussi sambandhit mitral patrake drishyaman karnyas anumati detat. yamule patrakachi jaadi aanee tyanche ennulasachya sapeksh visthapan mojata yete. parpurviy lamb-aksh drushyamadhye, 5 mimipeksha jaast mitral patrake jaad hone aanee 2 mimipeksha jaast shirshak visthapan heey abhijat mitral zadap prolapse darshavate.
patrakachi jaadi, patrakachya varshik jodanicha prakar aanee avtalpanachya aadhare prolapsed mitral zadapanche anek upprakaranmadhye vargikaran kele jaate. upprakaranche varnan abhijat, abhijat nasalele, samamiteey, asamamiteey, flail kinwa naun-flail asey kele jaau shakate.
khalee dilele serve mojmap praudh rugnancha sandarbh detat; teey mulanvar lagoo karane dishabhul karnare asoo shakate.
abhijat viruddha gairshastriy.
jevha mitral walvechi patrake mitral enulasachya uchch bindunchya 2 mimipeksha jaast unchivar visthapit hotat tevha prolapse hoto. mitral zadap patrakanchya jaadichya aadhare sthitee pudhe abhijat aanee abhijat nasalele upprakaranmadhye vibhagali jaau shakateh 5 miimii paryantche vargikaran abhijat manale jaate, tarr 5 mimichya palikade asalele kahihi abhijat mvp manale jaate.
samamiteey viruddha asamamiteey.
shastriy prolapsche samamiteey aanee asamamiteey asha done bhaganmadhye vibhajan kele jaau shakate, jyaa binduvar patrakachya tokanna mitral annulus jodale jaate. samamiteey aavarnamadhye, patrakachya tipa varshikavar eka samanya binduvar midatat. asamamiteey aavaran heey eka patrakadvare patrakadvare sandarbhat aalindakade visthapit karoon chinhankit kele jaate. visham prolapse asalele rugna, corde tendiniche sambhavya vighatan aanee flail patrak vikasit honyasah, mitral zadap gambhirpane bighadanyachi shakyata asate.
flail viruddha naun-flail.
asamamiteey prolapsche pudhe flail aanee naun-flailmadhye vibhajan kele jaate. jevha patrakachi tokachi bajoo baherchya dishene valate, davya aalindakade avtal hote, jyamule mitral zadap bighadte tevha flail prolapse hoto. flail patrakchi tivrata, toke ulgadanyapasun teey swarmel futanyaparyant badalate. patrak aanee corde tendiniche pruthakkaran heey patrak aniyantritpane chalate (mhanoon 'flail patrak'). asha prakare flail patrak asalelya rugnanmadhye naun-flail upprakar asalelya rugnanpeksha mitral regergitation praman jaast asate.
upchar.
mitral volve prolapse asalelya vyaktinna, visheshtah jyanchyat lakshane naheet, tyanna sahasa konatyahi upcharachi aavashyakta nasate. jyanna mitral walve prolapse aahe aanee diasotonomia lakshane (dhaddhadane, chhati dukhane) aahet tyanna beeta-blockercha fayda houu shakato (udaa.jee., propranolol, metoprolol, bisoprolol). purvicha stroke kinwa alind tantumayata asalelya lokanna espirin kinwa warferinsarkhya rakt patal parinam aushadhanchi aavashyakta asoo shakate. durmil ghatananmadhye jevha mitral zadap prolapse gambhir mitral regergitationshi sambandhit asate, tevha shastrakriya durusti kinwa mitral zadap badalane aavashyak asoo shakate. mitral zadap durusti samanyatah badalanyapeksha shreyaskar manali jaate. sadhyachya aii. see./aaha margdarshak tattve hrudayavikarachi lakshane vikasit honyapurvi lokanmadhye mitral zadap durust karnyas protsahan detat. lakshane asalelya lokanna, jyanchya davya nilayatil karya qamee jhalyache purave aahet kinwa jyanchya davya nilayatil vistar aahe, tyanchyakade tatadine laksh denyachi garaj aahe.
sansargjanya endocarditische pratibandh.
emm. vhee. pii. asalelya vyaktinna hrudayachya jivanusansarg honyacha dhoka jaast asato, jyala sansargjanya endocarditis mhanatat. haah dhoka samanya loksankhyemadhye sansargjanya endocarditischa dhoka andaje teen teey aathpat aahe. 2007 paryant, american haart association hallyachya shastrakriyesah aakramak prakriyepoorvi pratijaivike lihoon denyachi shifaras kelee. tyanantar, tyanni assa nishkarsh kadhala qee "dantchikitsesathi rogpratibandhak rogachi shifaras keval sansargjanya endocarditischya pratikool parinamachya sarvadhik jokhamishi sambandhit antarnihit hrudayavikarachya sthitee asalelya rugnansathi kelee pahije."
endocarditisasathi jababdar asalele anek jeev haloohaloo vadhanare asatat aanee niyamit rakt sanvardhanavar sahaj olakhata yet naheet (yaa jalad jivanna vadhanyasathi vishesh sanvardhanachya madhyamanchi aavashyakta asate). yamadhye hessec jivancha samavesh aahe, jeey samanya oropharengeal vanaspatincha bhag aahet aanee sthanik zadpanvar parinam parinam sansargjanya endocarditischya kadachit 5 teey 10 takke bhagasathi jababdar aahet. endocarditischa vichar kartana yaa jivanna lakshat thevane mahatvache aahe.
purvasoochana.
samanyatah emm. vhee. pii. saumya asate. tathapi, emm. vhee. pii. chya rugnanni fakt eka vegalya clickver navhe tarr kurkur kelee, tarr mrutyudar 15-20% itka vadhala aahe. mitral regergitation tivrata aanee ejection apurnankatil ghat heey mrutyuche pramukh bhavishyasuchak aahet.
gambhir emm. vhee. pii. asalelyansathi, guntagunt talhanyasathi aanee mrutyucha dhoka qamee karnyasathi, aavashyak asalyas, barkaine dekhrekh aanee upchar karanyachi shifaras kelee jaate. bahutansh prakarananmadhye, emm. vhee. pii. asalelya vyakti kiman lakshanansah samanya aanee nirogi jeevan jagoo shakatat.
rogpratibandhak.
jaree tyachya kahee guntagunt udbhavu shakatat, taree ekmat asey aahe qee mitral volve prolapse hii eka pratibandh karnyayogya sthitee nahee. lakshane kvachitach disun yet asalyane rugnachya jivanachya utpadaktevar parinam hott nahee. dhoomrapan talhane, garbhanirodhak vaparane (kaaran tyanna guthalya honyacha dhoka asato) aanee aarogya vyavsayikanchya dekharekhikhali vyayam aanee poshanache praman aanee prakar niyantrit kelyane vikar bighadanyas vilamb houu shakato.  krutrim hriday zadap asalelya rugnanmadhye sansargjanya endocarditischa dhoka jaast manla jaato, mitral prolapse asalelya rugnanmadhye mitral regergitations sahavarti aanee itar zadap rogashivay mitral prolapse asalelya rugnanmadhye qamee manla jaato.
pratijaivik rogpratibandhak.
mitral prolapse asalelyanna daat ghasane yasarkhya kahee niyamit nirjantukikaran nasalelya prakriyancha parinam mhanoon, hrudayachya uutincha jivanujanya sansarg, sansargjanya endocarditischa dhoka vadhato. tathapi, april 2007 madhye, american haart association kelelya abhyasat asey nirdharit kele hote qee hallyachya shastrakriyepurvi, udaharanarth dantchikitsa kinwa colonoscopy kinwa broncoscopidware biopsy, pratijaivike lihoon denyache dhoke rogpratibandhak pratijaivikanpeksha jaast asatat.
mahamarishastra.
varr varnan kelyapramane, mitral volve prolapschya nidanasathi kathor nikashanchya aadhi, samanya loksankhyemadhye mitral volve prolapschya ghatana mothya pramanat badalat hotya. kahee abhyasanni mitral volve prolapschya ghatanancha andaj 5 teey 15 takke kinwa tyahoon adhik asalyacha andaj vartavala aahe. 1985 chya eka abhyasat 35 takke nirogi kishoravayin mulanmadhye emm. vhee. pii. asalyache suchavale gele.
mitral volve anatomyche alikadil spashtikaran aanee trimiteey echocardiography vikasamule nidan nikashat sudharana jhaali aahe aanee yaa nikashannusar emm. vhee. pii. chaa kharaa prasar 2-3% assa andaj aahe. udaharanarth, framingham hriday abhyasacha eka bhag mhanoon, framingham, mamadhye mitral walve prolapscha prasar 2.4% asalyacha andaj hota. konatehi lakshaniy vay kinwa lingbhed naan hota, shastriy aanee gair-shastriy emm. vhee. pii. madhye jawaljawal samaan vibhajan hote. americetil 7 takke shavavichhedananmadhye emm. vhee. pii. disun yete.
ashiyai praudh lashkari lashkari taiwani mukhya hriday abhyasat assa andaj vartavanyat aala hota qee, 18 teey 39 vayogatatil hulionmadhil 2442 lokanpaiki, mitral walve prolapse 3.36% madhye jhaala. emm. vhee. pii. asalelya lokanmadhye boddy maas index qamee hota, vyayamashi sambandhit sharirik lakshane (chhatit dukhane, dyspania, vyayamachya darmyan dhaddhadane) aanee auscultationmadhye systolic click hote. emm. vhee. pii. asalelya 82 paiki 7 sahbhaginna saumya pectus utkhanan hote.
sanshodhan.
emm. vhee. pii. chya manvi aanee undaranchya abhyasat, davya nilay sanrachanevar emm. vhee. pii. aanee pragatishil fibrosis prabhavanmadhil sambandh aadhalala, jeey soochit karate qee aanvik aanee pesheey badalanche kaaran mhanje papillary aanee inferobasal myocardiumcha pratisad aahe.
pranyanmadhye.
2019 madhye biotechnology company, kayakalp bione vikasit keleli prayogik edeno-sambandhit vishanu (aav)-aadharit januk upchar paddhat. hrudayavikaracha zatka, mootrapind nikami hone, prakar 2 madhumeh aanee laththapana asha vay-sambandhit anek roganna ulatavanyasathi undaranvar hii paddhat yashasviritya aanee prabhavipane vaparali gelee. undaranni hrudayachya karyat 58 takke vaadh aanee mutrapindachya adhogatimadhye 75 takke ghat anubhavali asey abhyasat aadhalun aale. punarujjivit bione nantar hrudayatil vran uutinche sanchay thambavoon mitral volve rogachi pragati rokhanyasathi cavalier king charles spanielvar teech paddhat vaparnyasathi tufts vidyapithashi sahkarya kele. yaa upcharpaddhatit vishanucha vapar aanuvanshik upcharpaddhati denyasathi keela gela joou daag uutinchya sanchayat yogdan yogdan vishisht prathinanchya kruteela avarodhit karato.
itihas.
mitral walve prolapse' haah shabd jeey yanni tayar keela hota. 1966 madhye michael kriline, johnn brereton barlone varnan kelyapramane, mitral zadapchya 'billing' chya itar varnakavar sweekruti midavali.

