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به طور طبیعی دریچه ی میترال به اندازه ی سه انگشت(۶-۴ سانتیمتر مربع) باز می شود در موارد تنگی مشخص و شدید ،باز شدن دریچه به اندازه ی یک مداد (کمتر از۱سانتیمتر مربع) می رسد. دهلیز چپ برای تخلیه خون خود از خلال دهانه تنگ دریچه ناتوان بوده، و حجم خون زیادی درپشت آن تجمع یافته و موجب اتساع و هیپرتروفی دهلیز چپ ونیز پس زدن خون از دهلیز به عروق ریوی و احتقان گردش خون ریوی (ادم ریه) می شود.
بسیاری از افراد مبتلا به نارسایی دریچه میترال هیچ علامتی ندارند، ولی در بعضی از مبتلایان، علایم بالینی در طول سال‌ها ظاهر می‌شوند. علت دیر ظاهر شدن علایم بالینی در این افراد، جبران نارسایی دریچه توسط قلب است. با گذشت زمان تلاش بیش ازحد قلب منجر به بزرگ شدن بطن چپ می‌شود. برگشت خون به ریه‌‌ها نیز، باعث افزایش فشارخون ریوی می‌گردد. ممکن است با گذشت زمان علایم برگشت خون به آهستگی ظاهر شوند.
علایم نارسایی دریچه میترال عبارتند از: تنگی نفس و افزایش سرعت تنفس، خستگی مفرط، تپش قلب و سرفه.
برای مشاهده مقاله علایم و نشانه های نارسایی دریچه میترال، اینجا را کلیک کنید.
روش تشخیص تنگی دریچه میترال
بجز نوار قلب (الکتروکاردیوگرافی) عکس قفسه سینه که حساسیت کمی در تشخیص تنگی میترال دارند ، اکوکاردیوگرافی اولین و دقیقترین روش برای تشخیص این بیماری می باشد.
اکوکاردیوگرافی ترانس توراسیک اختصاصی ترین و حساس ترین روش غیر تهاجمی تشخیص تنگی است. با این روش می توان سطح دریچه ، گرادیان دریچه ای و فشار شریان ریوی و همراهی آن با نارسایی میترال و درگیری دریچه آئورت و تریکوسپید را ارزیابی کرد. اکوکاردیوگرافی از طریق مری روش مفیدی برای رویت جزئیات ساختمان دریچه، پیدا کردن وژتاسیون های کوچکتر از ۵ میلی لیتر یا ترومبوس های گوشک دهلیز چپ است که با اکوکاردیوگرافی ترانس توراسیک قابل مشاهده نمی باشد . و گاهی کاتتریزاسیون قلب به منظور تعیین شدت تنگی میترال می باشند .
اکوکاردیوگرافى بزرگ شدن دهلیز چپ، بطن چپ پرکار (Hyperdynamic LV)را نشان می دهد و اکوکاردیوگرافى داپلر در تشخیص و ارزیابى شدت MR کمک‌کننده است.
منبع: قلب ، کلینیک پیشگیری و ارتقای سلامت
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