Abstract
Prolapsing mitral valve is a common cardiac condition, occurring in approximately 16 million people in the United States alone. Primary prolapsing mitral valve may be familial or nonfamilial and may be associated with myxomatous degeneration of the mitral valve leaflets, such as occurs in Marfan syndrome and other connective tissue disorders. Secondary forms may be associated with such entities as rheumatic fever (especially after commissurotomy) and coronary artery disease (in the presence of ruptured chordae tendineae), and with such congenital conditions as interatrial defect and primary cardiomyopathy with outflow tract obstruction. Prolapsing mitral valve is characterized by late systolic murmur, mid-systolic click, or both. Arrhythmias occur in the form of benign premature atrial contraction, premature nodal contraction, and paroxysmal atrial tachycardia. As the patient ages, atrial flutter and atrial fibrillation tend to develop. In some chronic cases, especially those involving atrial fibrillation, systemic emboli may occur. Rare premature ventricular contractions may be largely benign, whereas more frequent premature ventricular contractions may lead to severe arrhythmic complexes such as ventricular tachycardia or ventricular fibrillation. With advancing age, atrioventricular conduction defects of varying degrees or sick sinus syndrome may necessitate a pacemaker installation. About one quarter of prolapsing mitral valve cases progress, with increasing mitral insufficiency and increasing enlargement of the left atrium and left ventricle, which at times leads to congestive heart failure. Coronary artery disease may occur with the severity commensurate with the patient's age group. About three quarters of patients with prolapsing mitral valve syndrome lead normal lives.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barlow J. B., Bosman C. K., Pocock W. A., Marchand P. Late systolic murmurs and non-ejection ("mid-late") systolic clicks. An analysis of 90 patients. Br Heart J. 1968 Mar;30(2):203–218. doi: 10.1136/hrt.30.2.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barlow J. B., Pocock W. A. The problem of nonejection systolic clicks and associated mitral systolic murmurs: emphasis on the billowing mitral leaflet syndrome. Am Heart J. 1975 Nov;90(5):636–655. doi: 10.1016/0002-8703(75)90229-x. [DOI] [PubMed] [Google Scholar]
- Bigger J. T., Jr, Reiffel J. A. Sick sinus syndrome. Annu Rev Med. 1979;30:91–118. doi: 10.1146/annurev.me.30.020179.000515. [DOI] [PubMed] [Google Scholar]
- Bloch A., Vignola P. A., Walker H., Kaplan A. D., Chiotellis P. N., Lees R. S., Myers G. S. Echocardiographic spectrum of posterior systolic motion of the mitral valve in the general population. J Clin Ultrasound. 1977 Aug;5(4):243–247. doi: 10.1002/jcu.1870050406. [DOI] [PubMed] [Google Scholar]
- Carpentier A. Cardiac valve surgery--the "French correction". J Thorac Cardiovasc Surg. 1983 Sep;86(3):323–337. [PubMed] [Google Scholar]
- Connolly S. J., Laupacis A., Gent M., Roberts R. S., Cairns J. A., Joyner C. Canadian Atrial Fibrillation Anticoagulation (CAFA) Study. J Am Coll Cardiol. 1991 Aug;18(2):349–355. doi: 10.1016/0735-1097(91)90585-w. [DOI] [PubMed] [Google Scholar]
- Cooley D. A., Gerami S., Hallman G. L., Wukasch D. C., Hall R. J. Mitral insufficiency due to myxomatous transformation: "Floppy valve syndrome". J Cardiovasc Surg (Torino) 1972 Jul-Aug;13(4):346–349. [PubMed] [Google Scholar]
- Cooley Denton A., Frazier O. Howard, Norman John C. MITRAL LEAFLET PROLAPSE: SURGICAL TREATMENT USING A POSTERIOR ANNULAR COLLAR PROSTHESIS. Cardiovasc Dis. 1976;3(4):438–443. [PMC free article] [PubMed] [Google Scholar]
- Corrigall D., Bolen J., Hancock E. W., Popp R. L. Mitral valve prolapse and infective endocarditis. Am J Med. 1977 Aug;63(2):215–222. doi: 10.1016/0002-9343(77)90235-2. [DOI] [PubMed] [Google Scholar]
- Fontana M. E., Sparks E. A., Boudoulas H., Wooley C. F. Mitral valve prolapse and the mitral valve prolapse syndrome. Curr Probl Cardiol. 1991 May;16(5):309–375. doi: 10.1016/0146-2806(91)90022-3. [DOI] [PubMed] [Google Scholar]
- Kerin N. Z., Edelstein J., Louridas G. Prolapsing mitral valve leaflet syndrome. A spectrum that includes cleft posterior mitral valve. Cathet Cardiovasc Diagn. 1976;2(1):77–85. doi: 10.1002/ccd.1810020110. [DOI] [PubMed] [Google Scholar]
- Mond H. G. The bradyarrhythmias: current indications for permanent pacing (part I). Pacing Clin Electrophysiol. 1981 Jul;4(4):432–442. doi: 10.1111/j.1540-8159.1981.tb03723.x. [DOI] [PubMed] [Google Scholar]
- Nishimura R. A., McGoon M. D., Shub C., Miller F. A., Jr, Ilstrup D. M., Tajik A. J. Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients. N Engl J Med. 1985 Nov 21;313(21):1305–1309. doi: 10.1056/NEJM198511213132101. [DOI] [PubMed] [Google Scholar]
- Procacci P. M., Savran S. V., Schreiter S. L., Bryson A. L. Prevalence of clinical mitral-valve prolapse in 1169 young women. N Engl J Med. 1976 May 13;294(20):1086–1088. doi: 10.1056/NEJM197605132942004. [DOI] [PubMed] [Google Scholar]
- REID J. V. Mid-systolic clicks. S Afr Med J. 1961 Apr 29;35:353–355. [PubMed] [Google Scholar]
- Roberts W. C., Dangel J. C., Bulkley B. H. Nonrheumatic valvular cardiac disease: a clinicopathologic survey of 27 different conditions causing valvular dysfunction. Cardiovasc Clin. 1973;5(2):333–446. [PubMed] [Google Scholar]
- Slater J., Gindea A. J., Freedberg R. S., Chinitz L. A., Tunick P. A., Rosenzweig B. P., Winer H. E., Goldfarb A., Perez J. L., Glassman E. Comparison of cardiac catheterization and Doppler echocardiography in the decision to operate in aortic and mitral valve disease. J Am Coll Cardiol. 1991 Apr;17(5):1026–1036. doi: 10.1016/0735-1097(91)90825-t. [DOI] [PubMed] [Google Scholar]
- Wooley C. F., Baker P. B., Kolibash A. J., Kilman J. W., Sparks E. A., Boudoulas H. The floppy, myxomatous mitral valve, mitral valve prolapse, and mitral regurgitation. Prog Cardiovasc Dis. 1991 May-Jun;33(6):397–433. doi: 10.1016/0033-0620(91)90005-7. [DOI] [PubMed] [Google Scholar]