| Repolarization abnormalities and arrhythmogenesis |
| ST depression repolarization |
| Increased QT interval |
| QT dispersion |
| T-wave flattening and inversion |
| Biphasic T-waves |
| Complex ventricular arrhythmias |
| Outflow tract alternating with papillary muscle or fascicular region |
| Diseased Purkinje tissue |
| MVP-related features |
| Excessive papillary muscles traction by the prolapsing leaflets |
| Mechanical endocardial stimulation by the elongated chordae |
| Endocardial friction lesions in the left ventricle by the chordae |
| Mitral valve structural alterations |
| Mitral annulus dilatation |
| Elongated mitral leaflet |
| Mitral annular disjunction |
| Annulus hypermobility |
| Bileaflet prolapse |
| Extravalvular factors |
| Autonomic nervous system dysfunction |
| Conduction system abnormalities |
| Fibromuscular dysplasia of small coronary arteries |
| Occult cardiomyopathies |
| Ventricular substrates |
| Left ventricular fibrosis at the level of papillary muscles and basal posterolateral segment |
| Aortic mitral continuity |
| Aortic sinuses of Valsalva |
| Suprapulmonary valve ectopics triggering polymorphic ventricular tachycardia and the atrioventricular valve annuli |
| Acute mitral regurgitation and cardiogenic pulmonary edema |
| Primary spontaneous chordal rupture |
