Abstract
To the Editor:Dr. Snell is correct in pointing out that we were not the first to report an association between spontaneous pneumothorax and mitral valve prolapse (MVP). Shortly after we completed our review of the literature, Brear et al (Thorax 1984;39:219) reported in an abstract that 80.9 percent of those with pneumothorax had MVP, compared 23.8 percent found in a control group (p<0.001). This study used M-mode echocardiography without a stated definition of the degree of mitral valve motion required for the diagnosis of MVP. It is preferable to use two-dimensional directed M-mode echocardiography in order to prevent false positive results. In addition, since mitral valve motion is a continuous and not a dicotomous variable (Wynne J. N Engl J Med 1986; 314:577-78), different degrees of mitral valve motion should be reported when looking for associations between MVP and other conditions. We were not aware of the report by Brear et al and are grateful to Dr. Snell for bringing it to our attention. To the Editor: Dr. Snell is correct in pointing out that we were not the first to report an association between spontaneous pneumothorax and mitral valve prolapse (MVP). Shortly after we completed our review of the literature, Brear et al (Thorax 1984;39:219) reported in an abstract that 80.9 percent of those with pneumothorax had MVP, compared 23.8 percent found in a control group (p<0.001). This study used M-mode echocardiography without a stated definition of the degree of mitral valve motion required for the diagnosis of MVP. It is preferable to use two-dimensional directed M-mode echocardiography in order to prevent false positive results. In addition, since mitral valve motion is a continuous and not a dicotomous variable (Wynne J. N Engl J Med 1986; 314:577-78), different degrees of mitral valve motion should be reported when looking for associations between MVP and other conditions. We were not aware of the report by Brear et al and are grateful to Dr. Snell for bringing it to our attention. Mitral Valve Prolapse, Spontaneous Pneumothorax, and Abnormal Lung CollagenCHESTVol. 91Issue 5PreviewTo the Editor: Full-Text PDF
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