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. 1983 Apr;49(4):334–340. doi: 10.1136/hrt.49.4.334

Prevalence of mitral prolapse by two dimensional echocardiography in healthy young women.

L S Wann, J R Grove, T R Hess, L Glisch, M J Ptacin, C V Hughes, C M Gross
PMCID: PMC481309  PMID: 6830667

Abstract

In order to establish the relative prevalence of mitral valve prolapse as diagnosed by two dimensional echocardiography, we studied 100 presumably healthy young women with two dimensional echocardiography and M-mode echocardiography, history, physical examination, electrocardiography, and phonocardiography. Two dimensional echocardiograms were obtained from parasternal, apical, and subcostal acoustic windows. Mitral valve prolapse was defined as extension of leaflet tissue cephalad to the plane of the mitral annulus into the left atrium; note was also made of any valvular thickening, redundancy, or excessive annular motion. One subject had a midsystolic click and late systolic murmur with evidence of mitral prolapse on both M-mode and two dimensional echocardiography. One subject had a midsystolic click with mitral prolapse demonstrated by two dimensional but not on M-mode echocardiography. One subject had a thick mitral valve on echocardiography but no click or murmur. Four subjects had midsystolic clicks without echocardiographic abnormalities. Mild artefactual pansystolic posterior bowing of the mitral valve on the M-mode echocardiogram could be produced in 20 subjects by incorrect transducer position. We conclude that the prevalence of mitral valve prolapse by two dimensional echocardiography is relatively low in presumably healthy young women. Use of two dimensional echocardiography may avoid overdiagnosis of mitral prolapse and identify a smaller group of individuals with true anatomical abnormalities of the mitral valve.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Cheitlin M. D., Byrd R. C. The click-murmur syndrome. A clinical problem in diagnosis and treatment. JAMA. 1981 Apr 3;245(13):1357–1361. [PubMed] [Google Scholar]
  3. Child J. S., Skorton D. J., Taylor R. D., Krivokapich J., Abbasi A. S., Wong M., Shah P. D. M mode and cross-sectional echocardiographic features of flail posterior mitral leaflets. Am J Cardiol. 1979 Dec;44(7):1383–1390. doi: 10.1016/0002-9149(79)90457-0. [DOI] [PubMed] [Google Scholar]
  4. Criley J. M., Lewis K. B., Humphries J. O., Ross R. S. Prolapse of the mitral valve: clinical and cine-angiocardiographic findings. Br Heart J. 1966 Jul;28(4):488–496. doi: 10.1136/hrt.28.4.488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Darsee J. R., Mikolich J. R., Nicoloff N. B., Lesser L. E. Prevalence of mitral valve prolapse in presumably healthy young men. Circulation. 1979 Apr;59(4):619–622. doi: 10.1161/01.cir.59.4.619. [DOI] [PubMed] [Google Scholar]
  6. DeMaria A. N., King J. F., Bogren H. G., Lies J. E., Mason D. T. The variable spectrum of echocardiographic manifestations of the mitral valve prolapse syndrome. Circulation. 1974 Jul;50(1):33–41. doi: 10.1161/01.cir.50.1.33. [DOI] [PubMed] [Google Scholar]
  7. DeMaria A. N., Neumann A., Lee G., Mason D. T. Echocardiographic identification of the mitral valve prolapse syndrome. Am J Med. 1977 Jun;62(6):819–829. doi: 10.1016/0002-9343(77)90648-9. [DOI] [PubMed] [Google Scholar]
  8. Dillon J. C., Haine C. L., Chang S., Feigenbaum H. Use of echocardiography in patients with prolapsed mitral valve. Circulation. 1971 Apr;43(4):503–507. doi: 10.1161/01.cir.43.4.503. [DOI] [PubMed] [Google Scholar]
  9. Gilbert B. W., Schatz R. A., VonRamm O. T., Behar V. S., Kisslo J. A. Mitral valve prolapse. Two-dimensional echocardiographic and angiographic correlation. Circulation. 1976 Nov;54(5):716–723. doi: 10.1161/01.cir.54.5.716. [DOI] [PubMed] [Google Scholar]
  10. Hancock E. W., Cohn K. The syndrome associated with midsystolic click and late systolic murmur. Am J Med. 1966 Aug;41(2):183–196. doi: 10.1016/0002-9343(66)90015-5. [DOI] [PubMed] [Google Scholar]
  11. Kerber R. E., Isaeff D. M., Hancock E. W. Echocardiographic patterns in patients with the syndrome of systolic click and late systolic murmur. N Engl J Med. 1971 Apr 1;284(13):691–693. doi: 10.1056/NEJM197104012841303. [DOI] [PubMed] [Google Scholar]
  12. Malcolm A. D., Bougher D. R., Kostuk W. J., Ahuja S. P. Clinical features and investigative findings in presence of mitral leaflet prolapse. Study of 85 consecutive patients. Br Heart J. 1976 Mar;38(3):244–256. doi: 10.1136/hrt.38.3.244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Markiewicz W., London E., Popp R. L. Effect of transducer placement on echocardiographic mitral valve motion. Am Heart J. 1978 Oct;96(4):555–556. doi: 10.1016/0002-8703(78)90172-2. [DOI] [PubMed] [Google Scholar]
  14. Markiewicz W., Stoner J., London E., Hunt S. A., Popp R. L. Mitral valve prolapse in one hundred presumably healthy young females. Circulation. 1976 Mar;53(3):464–473. doi: 10.1161/01.cir.53.3.464. [DOI] [PubMed] [Google Scholar]
  15. Markiewicz W., Stoner J., London E., Hunt S., Popp R. L. Effect of transducer placement on echocardiographic mitral valve systolic motion. Eur J Cardiol. 1976 Sep;4(3):359–366. [PubMed] [Google Scholar]
  16. Martin C. E., Hufnagel C. A., de Leon A. C., Jr Calcified atrial myxoma: diagnostic significance of the "systolic tumor sound" in a case presenting as tricuspid insufficiency. Am Heart J. 1969 Aug;78(2):245–250. doi: 10.1016/0002-8703(69)90015-5. [DOI] [PubMed] [Google Scholar]
  17. Mintz G. S., Kotler M. N., Segal B. L., Parry W. R. Two-dimensional echocardiographic recognition of ruptured chordae tendineae. Circulation. 1978 Feb;57(2):244–250. doi: 10.1161/01.cir.57.2.244. [DOI] [PubMed] [Google Scholar]
  18. Morganroth J., Jones R. H., Chen C. C., Naito M. Two dimensional echocardiography in mitral, aortic and tricuspid valve prolapse. The clinical problem, cardiac nuclear imaging considerations and a proposed standard for diagnosis. Am J Cardiol. 1980 Dec 18;46(7):1164–1177. doi: 10.1016/0002-9149(80)90287-8. [DOI] [PubMed] [Google Scholar]
  19. Morganroth J., Mardelli T. J., Naito M., Chen C. C. Apical cross-sectional echocardiography. Standard for the diagnosis of idiopathic mitral valve prolapse syndrome. Chest. 1981 Jan;79(1):23–28. doi: 10.1378/chest.79.1.23. [DOI] [PubMed] [Google Scholar]
  20. Pieroni D. R., Bell B. B., Krovetz L. J., Varghese P. J., Rowe R. D. Auscultatory recognition of aneurysm of the membranous ventricular septum associated with small ventricular septal defect. Circulation. 1971 Oct;44(4):733–739. doi: 10.1161/01.cir.44.4.733. [DOI] [PubMed] [Google Scholar]
  21. Popp R. L., Brown O. R., Silverman J. F., Harrison D. C. Echocardiographic abnormalities in the mitral valve prolapse syndrome. Circulation. 1974 Mar;49(3):428–433. doi: 10.1161/01.cir.49.3.428. [DOI] [PubMed] [Google Scholar]
  22. Popp R. L., Winkle R. A. Mitral-valve prolapse syndrome. JAMA. 1976 Aug 16;236(7):867–870. [PubMed] [Google Scholar]
  23. 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]
  24. REID J. V. Mid-systolic clicks. S Afr Med J. 1961 Apr 29;35:353–355. [PubMed] [Google Scholar]
  25. Ranganathan N., Silver M. D., Robinson T. I., Kostuk W. J., Felderhof C. H., Patt N. L., Wilson J. K., Wigle E. D. Angiographic-morphologic correlation in patients with severe mitral regurgitation due to prolapse of the posterior mitral valve leaflet. Circulation. 1973 Sep;48(3):514–518. doi: 10.1161/01.cir.48.3.514. [DOI] [PubMed] [Google Scholar]
  26. Roelandt J., Willems J., van der Hauwaert L. G., de Geest H. Clicks and sounds (whoops) in left-sided pneumothorax. Clinical and phonocardiographic study. Dis Chest. 1969 Jul;56(1):31–36. doi: 10.1378/chest.56.1.31. [DOI] [PubMed] [Google Scholar]
  27. Sahn D. J., Allen H. D., Goldberg S. J., Friedman W. F. Mitral valve prolapse in children: a problem defined by real-time cross-sectional echocardiography. Circulation. 1976 Apr;53(4):651–657. doi: 10.1161/01.cir.53.4.651. [DOI] [PubMed] [Google Scholar]
  28. Sze K. C., Shah P. M. Pseudoejection sound in hypertrophic subaortic stenosis: an echocardiographic correlative study. Circulation. 1976 Sep;54(3):504–509. doi: 10.1161/01.cir.54.3.504. [DOI] [PubMed] [Google Scholar]

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