Abstract
We describe the case of a 46-year old female with a Barlow’s disease (MVP) characterized by systolic curling of posterior left ventricular (LV) wall + significant mitral annular disjunction + complex ventricular arrhythmias + syncope + inverted T waves in inferolateral leads in whom a successful surgical mitral valve rapair determined the disappearance not only of the echocardiographic but also the electrocar-diographic abnormalities (in particular the inferolateral T waves inversion on basal electrocardiogram and the complex basal arrhythmic pattern). This case demonstrates that electrocardiographic abnormalities may disappear after the surgical correction of the mechanical stretch imposed on the inferior LV free wall by the prolapsing mitral valve leaflets. Electrocardiographic changes remain an important and easy marker to recognize for the identification of a high-risk subgroup of MVP patients.
Highlights
We describe the case of a 46-year old female with a Barlow’s disease (MVP) characterized by systolic curling of posterily or left ventricular (LV) wall + significant mitral annular disjunction + complex venn tricular arrhythmias + syncope + inverted T o waves in inferolateral leads in whom a successful surgical mitral valve rapair detere mined the disappearance of the s echocardiographic and the electrocaru diographic abnormalities
Electrocardiographic changes remain an important and easy marker to recm ognize for the identification of a high-risk o subgroup of MVP patients. on c Case Report N A 46-year old female with a Barlow’s months after surgery, we observed a normalization of LV function (LV ejection fraction increased from a pre-operative value of 45% to 60% post operation), the disappearance of the abnormal inward systolic movement of the basal inferior LV free wall, the absence of complex ventricular beats on the rest ECG along with the normalization of ventricular repolarization (previously negative T waves returned to a normal positive pattern (Figure 2B)
Uncertainty exist regarding the substrate of the electric instability in this form of MVP, even if a replacement-type fibrosis in infero-posterior myocardial region secondary to mechanical stretch of the myocardium by the prolapsing leaflets has been hypotetized as the trigger of ventricular arrhythmias.[2]
Summary
We describe the case of a 46-year old female with a Barlow’s disease (MVP) characterized by systolic curling of posterily or left ventricular (LV) wall + significant mitral annular disjunction + complex venn tricular arrhythmias + syncope + inverted T o waves in inferolateral leads in whom a successful surgical mitral valve rapair detere mined the disappearance of the s echocardiographic and the electrocaru diographic abnormalities (in particular the inferolateral T waves inversion on basal l electrocardiogram and the complex basal ia arrhythmic pattern).
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