What are the reasons for the polyphonic heart sounds?

summary

Polyphonic heart sound is the main clinical manifestation of Ebstein's syndrome. Ebstein's syndrome, also known as Ebstein's anomaly, refers to the fact that the tricuspid septal valve and / or the posterior valve occasionally move down with the anterior valve and attach to the right ventricular wall near the apex, accounting for about 0.5% - 1.0% of congenital heart disease. Ebstein's disease was first reported in 1866. This disease is also known as Ebstein anomaly. What are the reasons for the polyphonic heart sounds?

What are the reasons for the polyphonic heart sounds?

The etiology of the disease is not clear, occasionally family history reports, mothers who take lithium in early pregnancy, their offspring are prone to suffer from the disease. The main pathoanatomic features of this malformation are tricuspid valve depression, right ventricular atrialization and functional right ventricular cavity narrowing. In addition, other congenital malformations such as coarctation of aorta, ventricular septal defect, pulmonary valve stenosis or atresia, patent ductus arteriosus or corrected transposition of great vessels can be found in a few cases. In the latter case, anatomically, the right ventricle is the left ventricle with systemic circulation. Clinically, there may be mitral regurgitation, so it is called left Ebstein malformation.

Congenital heart disease is caused by environmental factors, genetic factors and two factors? In order to break the link of interaction between environmental factors and genetic factors, we should pay attention to premarital examination, avoid consanguineous marriage and accept genetic counseling. More importantly, we should try to find, avoid and prevent environmental factors that may cause adverse changes in genetic tendency during pregnancy, such as virus infection, drugs, alcohol and maternal diseases, It's the key to primary prevention.

Prenatal diagnosis: at 16-20 weeks of gestation, amniotic fluid was extracted through abdominal puncture of amniotic membrane for amniotic fluid cell culture, chromosome analysis, gene diagnosis and enzyme activity determination. The metabolites, special proteins and enzyme activity in amniotic fluid can also be detected by vaginal aspiration of villi at 8-12 weeks of gestation, It has great value for congenital heart disease caused by single gene mutation and chromosome aberration.

matters needing attention

Once the diagnosis of congenital heart disease is confirmed, the fundamental method of treatment is to perform surgery to completely correct the cardiovascular malformation, so as to eliminate the pathophysiological changes caused by the malformation. Those who are not operated or can not be operated temporarily should avoid overwork according to the condition, so as to avoid heart failure. If heart failure occurs, anti heart failure treatment should be taken. Prevention and treatment of complications, all patients with congenital heart disease in the implementation of invasive examination or treatment, including cardiac catheterization, tooth extraction, tonsillectomy, etc. should be routinely used antibiotics to prevent infective endocarditis.