scholarly journals Mitral valve prolapse with ventricular arrhythmias: does it carries a worse prognosis?

2021 ◽  
Vol 23 (Supplement_E) ◽  
pp. E77-E82
Author(s):  
Gloria Vassilikì Coutsoumbas ◽  
Giuseppe Di Pasquale

Abstract The association of mitral valve prolapse (MVP) with ventricular arrhythmias has long been known and has generally been considered a benign condition. In recent years, however, a small but not negligible risk of malignant ventricular arrhythmias and sudden cardiac death has been documented in the large population of subjects with MVP. The main predictors of major arrhythmic risk identified so far include history of syncope, ventricular repolarization abnormalities in the inferior-lateral electrocardiogram leads, right bundle branch block morphology of ventricular ectopic beats, finding of areas of myocardial fibrosis on cardiac magnetic resonance, and mitral annular disjunction (MAD) on echocardiogram, as well as a possible pro-arrhythmic genetic substrate. The stratification of arrhythmic risk, with the active search for red flags and in particular of MAD, is important to identify patients with the malignant arrhythmic variant of MVP in whom to implement closer surveillance and possible therapeutic interventions.

2020 ◽  
Vol 8 (1) ◽  
pp. 2
Author(s):  
Idit Yedidya ◽  
Aniek L. van Wijngaarden ◽  
Nina Ajmone Marsan

Mitral valve prolapse (MVP) is a common valvular disease, which may remain a benign condition for a long period of time. However, some patients experience malignant ventricular arrhythmias and sudden cardiac death (SCD). It is still largely unknown how to risk-stratify these patients, and no specific recommendations have been proposed to help the clinical decision-making. We present the case of a young man whose first clinical presentation was an out-of-hospital cardiac arrest and was subsequently diagnosed with MVP. We highlighted the possible risk factors for SCD and the challenges in the clinical management of these patients.


2018 ◽  
Vol 2018 (1) ◽  
Author(s):  
Leticia Fernández-Friera ◽  
Rafael Salguero ◽  
Luca Vannini ◽  
Ana Fidalgo Argüelles ◽  
Fernando Arribas ◽  
...  

Mitral valve prolapse (MVP) is a common and benign condition. However, some anatomic forms have been recently associated with life-threatening ventricular arrhythmias and sudden cardiac death. Imaging MVP holds the promise of individualized MVP risk assessment. Noninvasive imaging techniques available today are playing an increasingly important role in the diagnosis, prognosis and monitoring of MVP. In this article, we will review the current evidence on arrhythmogenic MVP, with special focus on the utility of echocardiography and CMR for identifying benign and ‘‘malignant’’ forms of MVP. The clinical relevance of this manuscript lies in the value of imaging technology to improve MVP risk prediction, including those arrhythmic-MVP cases with a higher risk of sudden cardiac death. 


PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 789-790
Author(s):  

Mitral valve prolapse (MVP) is generally a benign condition characterized by the protrusion of the mitral valve leaflets into the left atrium during systole. The prevalence of MVP in individuals under the age of 18 years is estimated to be 5% but is higher in those with Marfan's syndrome and other collagen vascular disorders.1 A midsystolic nonejection click with or without a late systolic murmur is the auscultatory hallmark of this syndrome. The diagnosis of MVP in children and adolescents should be based primarily on auscultatory findings and not on minor echocardiographic findings.1 The prognosis in children and adolescents with isolated MVP appears to be excellent and complications are rare. In 553 children, aged 15 days to 18 years, who were involved in studies with a follow-up period of 6 to 9 years, the following were reported: subacute bacterial endocarditis (one case), cerebral vascular accidents (two cases), migraine headaches (four cases), and chest pain (12 cases).2,3 Only four cases of sudden death have been reported in patients younger than 20 years of age.1-4 In a study of 103 patients with MVP, 16% were found to have premature ventricular beats during exercise electrocardiography (ECG) (exercise test).3 Thirty-eight percent were found to have premature ventricular contractions (PVCs) on 24-hour ECG (Holter) monitoring. This study, however, does not report the true prevalence of dysrhythmias because all these subjects had been referred to a pediatric cardiologist for evaluation. It is likely that these reported numbers are high because asymptomatic patients are less often referred.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 451-454
Author(s):  
Stephen S. Hirschfeld ◽  
Charles Rudner ◽  
Clyde L. Nash ◽  
Eliezer Nussbaum ◽  
Eleanor M. Brower

Seventy-four patients with adolescent scoliosis underwent cardiac examination and M-mode echocardiography to detect the presence of mitral valve prolapse (MVP). Twenty-one (28%) had echocardiographic evidence of MVP, whereas 18 had auscultatory findings of a nonejection click or late systolic murmur. A subset of 41 patients had a family history of scoliosis and 37% had MVP. The incidence of MVP increased to 41% when a first degree relative, such as a sibling, parent, or offspring, had scoliosis. Thirty-six patients with scoliosis had additional thoracic hypokyphosis (straight back) and 13 (36%) had MVP. The incidence of MVP was 48% when the scoliosis and hypokyphosis were hereditary and increased to 53% when a familial history of skeletal abnormality was present. This study indicates a high incidence of MVP in patients with scoliosis and hypokyphosis, especially when the skeletal abnormality is familial. It suggests that the cardiac and skeletal systems may be affected by a generalized soft-tissue defect.


2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
L A Dejgaard ◽  
E T Skjolsvik ◽  
O H Lie ◽  
M Ribe ◽  
M K Stokke ◽  
...  

Author(s):  
Paul J. Marano ◽  
Lisa J. Lim ◽  
Jose M. Sanchez ◽  
Raza Alvi ◽  
Gregory Nah ◽  
...  

2014 ◽  
Vol 2014 (may14 1) ◽  
pp. bcr2014205055-bcr2014205055 ◽  
Author(s):  
A. R. Rajani ◽  
V. Murugesan ◽  
F. O. Baslaib ◽  
M. A. Rafiq

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