HEART DISEASES — the inborn or acquired morphological changes of the valve device, partitions or walls of heart and the large vessels departing from it, reformative conditions of an endocardiac hemodynamics or the blood circulations and the circulatory unefficiencies which are often leading to development breaking normal dissociation between big and small circles.
Inborn P. of page arise hl. obr. as anomalies of development of heart in the pre-natal period (see. Heart diseases inborn ). The pages acquired by P. develop as a result of a disease or the injury of heart postponed after the birth (see. acquired ).
Inborn P. pages make 1 — 2%, and acquired — 20 — 25% of all organic lesions of heart. In view of extreme variety of P. of page of their uniform standard classification is not present. In clinical classification, widespread in our country, of the most often found inborn P. of page offered E. N. Meshalkin (1962), the last divide into two basic groups. Inborn P. of page with early cyanosis enter into the first group, one of to-rykh leads to decrease in a blood-groove in a small circle as, e.g. Fallo triad (see), an atresia of a right ventricle, and others, on the contrary, are followed by a hypervolemia or hypertensia of a small circle, napr, not completely compensated transposition of vessels and arteriovenous pulmonary fistula. Inborn P. the pages of pale type including options with secondary cyanosis (the compensated transposition of vessels, Eyzenmenger's complex, Lyutambashe's syndrome) without cyanosis, napr, not overgrown concern to the second group arterial channel (see), defect of an interventricular partition (Tolochinova — Roget a disease), defect of an interatrial partition, vicious falling of pulmonary veins into the right auricle, and also defects with existence of the isolated locks of vessels, napr, inborn stenoses of mouths of a pulmonary artery and aorta and an isthmus of an aorta (see. Coarctation of an aorta ).
The pages acquired by P. in V. F. Zelenin (1952) classification are divided on isolated and combined. In the classification offered H. M. Mukharlyamov and soavt. (1978), the attempt to unify terminology of the pages acquired by P. taking into account their origin, anatomic and functional features, degrees of manifestation of defect and existence of complications is made. The name of defect includes the name of the struck valve and the characteristic of defect in the form of insufficiency of the valve or a stenosis of an opening. It is recommended to designate P. of page as combined at a combination of defeats of one valve (a stenosis and insufficiency) and as combined — at defeat of several valves. Defects of the mitral valve include insufficiency of the mitral valve, a mitral stenosis, the combined mitral defect with dominance of insufficiency or a stenosis or without accurate dominance of insufficiency or a stenosis. Defects of the three-leaved (tricuspid) valve are similarly subdivided. Defects of the aortal valve include insufficiency of the aortal valve, a stenosis of the mouth of an aorta, the combined aortal defect with dominance of insufficiency or a stenosis or without accurate dominance of insufficiency or a stenosis. The acquired defects of the valve of a pulmonary trunk usually are shown by insufficiency of the valve of a pulmonary trunk. The recommended formulation of the diagnosis at the combined defects is explained by the following example: «mitral and aortal and tricuspid defect — mitral defect with dominance of insufficiency, a stenosis of the mouth of an aorta, insufficiency of the three-leaved valve». Before the name of defect specify its origin. On the basis of the analysis of these clinical and tool trials allocate three degrees of manifestation of insufficiency or a stenosis: I \insignificant, II — moderate, III — sharp. After the name P. of page give complications: a circulatory unefficiency on the standard classification, cardiac asthma, disturbances of a heart rhythm, fibrinferment and an embolism.
In a final stage of development of the nek-ry acquired and inborn P. of page owing to the expressed disturbance of the central hemodynamics all cardial cavities increase that is designated as a cardiomegaly.
H. M. Mukharlyamov.