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Overview

概述

Mitral valve regurgitation — also called mitral regurgitation, mitral insufficiency or mitral incompetence — is a condition in which your heart's mitral valve doesn't close tightly, allowing blood to flow backward in your heart. If the mitral valve regurgitation is significant, blood can't move through your heart or to the rest of your body as efficiently, making you feel tired or out of breath.

二尖瓣閉鎖不全，也稱作二尖瓣逆流，是一種心臟二尖瓣無法緊密閉合的疾病，它會使血液逆流回到心臟中。如果二尖瓣閉鎖不全的情況嚴重，血液將不能有效地流過心臟或身體的其他部位，使你感到疲倦或呼吸困難。

Treatment of mitral valve regurgitation depends on how severe your condition is, whether it's getting worse and whether you have symptoms. For mild leakage, treatment is usually not necessary.

二尖瓣閉鎖不全的治療取決於病情有多嚴重、病情是否惡化以及是否有顯示出症狀。對於輕度的滲漏，通常不需要進行治療。

You may need heart surgery to repair or replace the valve for severe leakage or regurgitation. Left untreated, severe mitral valve regurgitation can cause heart failure or heart rhythm problems (arrhythmias). Even people without symptoms may need to be evaluated by a cardiologist and surgeon trained in mitral valve disease to determine whether early intervention may be beneficial.

你可能需要進行心臟手術來修復或更換嚴重滲漏或逆流的瓣膜。若不治療，嚴重的二尖瓣閉鎖不全會導致心衰竭或心律問題（心律不整）。即使沒有症狀的人也可能需要由心臟科醫生和接受過二尖瓣疾病培訓的外科醫生進行評估，以確定是否需要即早治療。

Symptoms

症狀

Some people with mitral valve disease might not experience symptoms for many years. Signs and symptoms of mitral valve regurgitation, which depend on its severity and how quickly the condition develops, can include:

一些患有二尖瓣疾病的人可能多年不會出現症狀。視其嚴重程度和病情發展速度，二尖瓣閉鎖不全的徵兆和症狀可包括：

• Abnormal heart sound (heart murmur) heard through a stethoscope

通過聽診器可以聽到異常的心音（心雜音）

• Shortness of breath (dyspnea), especially when you have been very active or when you lie down

呼吸短促（呼吸困難），特別是在劇烈活動或躺下時

• Fatigue

疲勞

• Heart palpitations — sensations of a rapid, fluttering heartbeat

心悸，心跳快速、顫動的感覺

• Swollen feet or ankles

腳或腳踝腫脹

Mitral valve regurgitation is often mild and progresses slowly. You may have no symptoms for many years and be unaware that you have this condition, and it might not progress.

二尖瓣閉鎖不全通常較輕微且病情演變緩慢。你可能多年都沒有出現任何症狀，也不知道有這種疾病，而且可能病情都沒有任何變化。

Your doctor might first suspect you have mitral valve regurgitation upon detecting a heart murmur. Sometimes, however, the problem develops quickly, and you may experience a sudden onset of severe signs and symptoms.

在檢測到心雜音時，醫生可能會先懷疑你有二尖瓣閉鎖不全。然而，有時候問題可能會迅速惡化，使你突然出現嚴重的徵兆和症狀。

When to see a doctor

何時該去看醫生

If your doctor hears a heart murmur when listening to your heart with a stethoscope, he or she may recommend that you visit a cardiologist and get an echocardiogram. If you develop symptoms that suggest mitral valve regurgitation or another problem with your heart, see your doctor right away. Sometimes the first indications are actually those of mitral valve regurgitation's complications, including heart failure, a condition in which your heart can't pump enough blood to meet your body's needs.

若醫生用聽診器聽到心雜音時，他/她可能會建議你去看心臟科醫生並接受心臟超音波檢查。如果你有二尖瓣閉鎖不全或心臟其他問題的症狀產生，請立即就醫。有時候，第一個顯現的適應症其實是二尖瓣閉鎖不全的併發症，包括心衰竭，一種心臟無法幫浦足夠血液來滿足身體需要的疾病。

Causes

原因

Your heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (leaflets or cusps) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow through your heart to your body.

心臟有四個可以保持血液送往正確方向的瓣膜。這些瓣膜包括二尖瓣、三尖瓣、肺動脈瓣和主動脈瓣。每一個瓣膜都有一個每次心搏動時用來開啟和閉合一次的皮瓣（瓣葉或瓣尖）。有時候瓣膜會無法正常開合，從而破壞通過心臟送往身體的血液流動。

In mitral valve regurgitation, the valve between the upper left heart chamber (left atrium) and the lower left heart chamber (left ventricle) doesn't close tightly, causing blood to leak backward into the left atrium (regurgitation).

在二尖瓣閉鎖不全中，左上心室（左心房）和左下心室（左心室）之間的瓣膜無法緊密關閉，導致血液回漏到左心房（逆流）。

Mitral valve regurgitation causes

二尖瓣閉鎖不全的原因

Mitral valve regurgitation can be caused by problems with the mitral valve, also called primary mitral valve regurgitation. Diseases of the left ventricle can lead to secondary or functional mitral valve regurgitation.

二尖瓣閉鎖不全可能是由二尖瓣問題所引起，也稱為原發性二尖瓣閉鎖不全。左心室的疾病則會導致二級或功能性二尖瓣閉鎖不全。

Possible causes of mitral valve regurgitation include:

二尖瓣閉鎖不全可能的原因包括：

• Mitral valve prolapse. In this condition, the mitral valve's leaflets bulge back into the left atrium during the heart's contraction. This common heart defect can prevent the mitral valve from closing tightly and lead to regurgitation.

二尖瓣脫垂。指二尖瓣的瓣葉在心縮期凸回到左心房。這種常見的心臟缺陷將阻止二尖瓣緊密關閉並導致逆流。

• Damaged tissue cords. Over time, the tissue cords that anchor the flaps of the mitral valve to the heart wall may stretch or tear, especially in people with mitral valve prolapse. A tear can cause leakage through the mitral valve suddenly and may require repair by heart surgery. Trauma to the chest also can rupture the cords.

損壞的腱索。將二尖瓣的皮瓣固定在心臟壁上的腱索可能會隨著時間的推移拉伸或撕裂，尤其是在有二尖瓣脫垂的人中更可能發生。撕裂可能突然導致二尖瓣滲漏，並且可能需要通過心臟手術進行修復。胸部的創傷也會使腱索破裂。

• Rheumatic fever. Rheumatic fever — a complication of untreated strep throat — can damage the mitral valve, leading to mitral valve regurgitation early or later in life. Rheumatic fever is now rare in the United States, but it's still common in developing countries.

風濕熱。風濕熱是由未治療的鏈球菌性咽喉炎所導致的併發症，它會對二尖瓣造成破壞，遲早會導致二尖瓣閉鎖不全。風濕熱現今在美國比較少見，但在發展中國家仍然很常見。

• Endocarditis. The mitral valve may be damaged by an infection of the lining of the heart (endocarditis) that can involve heart valves.

心內膜炎。二尖瓣可能會被感染的心臟內膜（心內膜炎）所破壞，這種感染還可能包含心臟瓣膜。

• Heart attack. A heart attack can damage the area of the heart muscle that supports the mitral valve, affecting the function of the valve. If the damage is extensive enough, a heart attack can cause sudden and severe mitral valve regurgitation.

心臟病發作。心臟病發作會破壞支撐二尖瓣的心肌區域，影響瓣膜的功能。如果造成破壞的範圍太大，心臟病發作可能就會導致突發的和嚴重的二尖瓣閉鎖不全。

• Abnormality of the heart muscle (cardiomyopathy). Over time, certain conditions, such as high blood pressure, can cause your heart to work harder, gradually enlarging your heart's left ventricle. This can stretch the tissue around your mitral valve, which can lead to leakage.

心肌異常（心肌症）。某些疾病隨著時間的推移，會導致心臟需要更加努力的運作，例如高血壓，這將逐漸擴大心臟的左心室，拉伸二尖瓣周圍的組織，從而導致滲漏。

• Trauma. Experiencing trauma, such as in a car accident, can lead to mitral valve regurgitation.

外傷。經歷過像是車禍這樣的創傷，可能導致二尖瓣閉鎖不全。

• Congenital heart defects. Some babies are born with defects in their hearts, including damaged heart valves.

先天性心臟病。有些嬰兒出生時心臟就有缺陷，包括心臟瓣膜受損。

• Certain drugs. Prolonged use of certain medications can cause mitral valve regurgitation, such as those containing ergotamine (Cafergot, Migergot) that are used to treat migraines and other conditions.

某些藥物。長期使用某些藥物可能造成二尖瓣閉鎖不全，例如藥物中含有用於治療偏頭痛和其他疾病的麥角胺（例如Cafergot，Migergot）。

• Radiation therapy. In rare cases, radiation therapy for cancer that is focused on the chest area can lead to mitral valve regurgitation.

放射治療。在極少數的情況下，針對胸部區域的癌症放射治療可能導致二尖瓣閉鎖不全。

• Atrial fibrillation. Atrial fibrillation is a common heart rhythm problem that can be a potential cause of mitral valve regurgitation.

心房顫動。心房顫動是一種常見的心律問題，它可能是造成二尖瓣閉鎖不全的潛在原因。

Risk factors

危險因子

Several factors can increase your risk of mitral valve regurgitation, including:

有幾個因子會增加二尖瓣閉鎖不全的危險，包括：

• A history of mitral valve prolapse or mitral valve stenosis. However, having either condition doesn't necessarily mean you'll develop mitral valve regurgitation. A family history of valve disease also can increase risk.

二尖瓣脫垂或二尖瓣狹窄的病史。然而，有其中一種疾病並不一定代表會產生二尖瓣閉鎖不全。而有瓣膜疾病的家族病史也會增加危險。

• A heart attack. A heart attack can damage your heart, affecting the function of the mitral valve.

心臟病發作。心臟病發作可能會損害心臟，影響二尖瓣的功能。

• Heart disease. Certain forms of heart disease, such as coronary artery disease, can lead to mitral valve regurgitation.

心臟病。某些類型的心臟病，例如冠狀動脈疾病，會導致二尖瓣閉鎖不全。

• Use of certain medications. People who take drugs containing ergotamine (Cafergot, Migergot) and similar medicines for migraines or who take cabergoline have an increased risk of mitral regurgitation. Similar problems were noted with the appetite suppressants fenfluramine and dexfenfluramine, which are no longer sold.

使用某些藥物。服用含有能治療偏頭痛的麥角胺（例如Cafergot，Migergot）和類似的藥物或服用卡麥角林的人，患有二尖瓣閉鎖不全的危險會增加。不再販售的食慾抑製劑芬氟拉明和右芬氟拉明也出現過類似的問題。

• Infections such as endocarditis or rheumatic fever. Infections or the inflammation they cause can damage the mitral valve.

感染如心內膜炎或風濕熱。它們所引起的感染或炎症會破壞二尖瓣。

• Congenital heart disease. Some people are born with an abnormal mitral valve prone to regurgitation.

先天性心臟病。有些人天生就有二尖瓣異常的問題，容易發生逆流的情形。

• Age. By middle age, many people have some mitral valve regurgitation caused by natural deterioration of the valve.

年齡。很多人到了中年，瓣膜就會自然惡化，進而造成一些二尖瓣閉鎖不全的情形。

Complications

併發症

When it's mild, mitral valve regurgitation usually does not cause any problems. However, severe mitral valve regurgitation can lead to complications, including:

當它還很輕微時，二尖瓣閉鎖不全通常不會引起任何問題。然而，嚴重的二尖瓣閉鎖不全會導致的併發症有：

• Heart failure. Heart failure results when your heart can't pump enough blood to meet your body's needs. Severe mitral valve regurgitation places an extra strain on the heart because, with blood pumping backward, there is less blood going forward with each beat. The left ventricle gets bigger and, if untreated, weakens. This can cause heart failure.

Also, pressure builds in your lungs, leading to fluid accumulation, which strains the right side of the heart.

心衰竭。當心臟無法幫浦足夠的血液來滿足身體的需求時，就會導致心衰竭。嚴重的二尖瓣閉鎖不全會對心臟造成額外的壓力，因為血液若在幫浦時回流，每次搏動時血液的順流量就會比較少。使左心室變大，而且若不治療則更會使其衰弱，導致心衰竭。

此外，積在肺部的壓力會導致液體積聚，使心臟右側受壓。

• Atrial fibrillation. The stretching and enlargement of your heart's left atrium may lead to this heart rhythm irregularity in which the upper chambers of your heart beat chaotically and rapidly. Atrial fibrillation can cause blood clots, which can break loose from your heart and travel to other parts of your body, causing serious problems, such as a stroke if a clot blocks a blood vessel in your brain.

心房顫動。心臟左心房的拉伸與變大可能導致心律不規則，使心臟的上腔室混亂而迅速地跳動。心房顫動會造成血凝塊，它可能會從心臟中鬆脫並隨血液流動到身體的其他部位，導致嚴重的問題，例如若血凝塊阻塞在大腦的血管中，則會造成中風。

• Pulmonary hypertension. If you have long-term untreated or improperly treated mitral regurgitation, you can develop a type of high blood pressure that affects the vessels in the lungs (pulmonary hypertension). A leaky mitral valve can increase pressure in the left atrium, which can eventually cause pulmonary hypertension. This can lead to heart failure on the right side of the heart.

肺動脈高壓。若二尖瓣閉鎖不全長期未治療或治療不當，可能會出現一種影響肺部血管的高血壓（肺動脈高壓）。滲漏的二尖瓣會增加左心房的壓力，最終導致肺動脈高壓，進而造成心臟右側的心衰竭。