Valve Prolapse In Patients Research Articles

Mitral valve prolapse in anxiety neurosis (panic disorder)

Our purpose was to determine the incidence of mitral valve prolapse in patients with anxiety neurosis or panic disorder, with symptoms including recurrent anxiety attacks, dyspnea, palpitations, chest pain, dizziness, and paresthesias. Twenty-one patients and 20 age- and sexmatched normal controls were studied. Objective cardiac abnormalities were significantly (p < 0.05) more frequent in the patient group as compared to the control group; these comprised echocardiographic prolapse, ST-T abnormalities on resting ECG, premature ventricular contractions on exercise ECG, and the combination of echo prolapse with clicks/murmurs or exercise-induced PVC. We conclude that patients with anxiety neurosis or panic disorder may also have evidence of an organic abnormality-the mitral prolapse syndrome.

Conduction abnormalities associated with mitral valve prolapse in patients with normal coronary arteries

Conduction abnormalities associated with mitral valve prolapse in patients with normal coronary arteries

Mitral valve prolapse due to coronary artery disease

Controversy exists concerning the etiologic role of coronary artery disease in the prolapsing mitral valve leaflet syndrome. A 35 year old man with progressive coronary artery disease is described. Auscultation before and after his first myocardial infarction revealed only a fourth heart sound; subsequent left ventricular cineangiography demonstrated normal anatomy and function of the mitral valve, despite extensive wall motion abnormalities. Six months later he experienced another myocardial infarction after which the typical mid-systolic click, late systolic murmur of mitral valve prolapse developed. A second left ventricular cineanglogram at this time revealed mid-systolic mitral valve prolapse and mitral regurgitation. This patient's course indicates that myocardial damage from coronary artery disease can cause mitral valve prolapse in patients without preexisting redundant mitral valve tissue.

Mitral valve prolapse in patients with coronary artery disease. Echocardiographic-angiographic correlation.

Echocardiography was performed in 25 consecutive patients with angina pectoris and angiographically demonstrable coronary artery disease. Left ventricular echograms detected late or pansystolic mitral valve bowing suggesting of mitral valve proplapse in 6/25 (24%). Left ventricular angiography showed prolapse of the posterior mitral leaflet in 15/25 (60%), including 5 detected by echocardiography. Significant triple vessel coronary disease was present in 11 of 15 patients with prolapsed mitralvalve. In each of the latter a greater than 90 per cent obstructive lesion was noted in at least one coronary artery: right coronary artery, 9 subjects (82%); left circumflex coronary artery, 5 patients (33%); and left anterior descending coronary artery, 4 patients (27%). Of 15 subjects with angiographic evidence of mitral valve prolapse, 13 had left ventricular asynergy-inferior or inferoposterior in 8 subjects (62%) and anterior or anteroapical in 5 subjects (38%). Eleven subjects had vectorcardiographic evidence of transmural myocardial infarction-inferior or inferoposterior in 9 (82%) and anteroseptal in 2 (18%). A single subject with mitral valve prolapse had mild mitral regurgitation. It is concluded that: (1) coexisting prolapse of the posterior mitral valve leaflet and coronary artery disease is usually associated with triple vessel obstructive lesions, (2) severe right coronary disease, inferior left ventricular wall asynergy, and inferior myocardial infarction are important angiographic and vectorcardiographic correlates, and (3) echocardiography will detect such mitral valve prolapse in only one-third of affected cases.

Mitral valve prolapse in coronary artery disease

Mitral valve motion, left ventricular segmental contraction and severity of arterial stenosis were analyzed in 92 patients with coronary artery disease and 28 patients with “atypical chest pain” and normal coronary arteriograms. Mitral valve motion was evaluated for the presence or absence of leaflet prolapse. Segmental contraction was evaluated by calculating the percent shortening of six chords of the left ventricle measured from right anterior oblique ventriculograms. The severity of disease in each coronary vessel (left anterior descending, left circumflex and right coronary) was graded on a scale of 1 (0 to 30 percent stenosis) to 5 (complete occlusion). Mitral valve prolapse was not suspected clinically but observed angiographically in 15 of 92 patients with coronary artery disease and in 5 of 28 patients with normal coronary arteriograms. In nine patients with coronary artery disease, the prolapse was restricted to the posterior leaflet, in five it was in both the anterior and the posterior leaflets and in one patient in the anterior leaflet only. Mitral regurgitation was noted in seven patients with coronary artery disease; it was mild in six and moderate in one. Among the patients with coronary artery disease, 12 of the 15 (80 percent) with mitral valve prolapse had left ventricular asynergy compared with 63 of the 77 (82 percent) without valve prolapse. The mean scores for severity of disease in the left anterior descending, circumflex and right coronary arteries were, respectively, 4.2, 2.5 and 3.2 in the patients with valve prolapse and 4.2, 2.2 and 3.5 in those without prolapse. In summary, there was no significant correlation between mitral valve prolapse and distribution of coronary arterial obstructions or abnormal patterns of left ventricular segmental contraction. There was a high frequency of mitral valve prolapse in patients with severe coronary artery disease and in those with normal coronary arteriograms and atypical chest pain.

PURE MITRAL INSUFFICIENCY OF RHEUMATIC ORIGIN IN ADULTS

Article1 May 1953PURE MITRAL INSUFFICIENCY OF RHEUMATIC ORIGIN IN ADULTSE. R. MOVITT, M.D., F.A.C.P., B. GERSTL, M.D.E. R. MOVITT, M.D., F.A.C.P.Search for more papers by this author, B. GERSTL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-38-5-981 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAppraisal of the significance of systolic murmurs has undergone various changes in the last few decades. Originally it was thought that every patient with a systolic murmur had heart disease. Thus a diagnosis of mitral insufficiency of rheumatic origin was frequently made solely on the basis of an apical systolic murmur. Many a prospective recruit with such a murmur was rejected for military service even in the absence of any other evidence of cardiac involvement. This point of view was prevalent here and abroad before the first World War. 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FrothinghamHaas CGM: Rupture of normal chordae tendineae of mitral valve, Am. Heart J. 9: 492, 1934. CrossrefGoogle Scholar25. ElkinSosmanHarkenDexter MMCDEL: Systolic expansion of the left auricle in mitral regurgitation, New England J. Med. 246: 958, 1952. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Oakland, California*Received for publication December 22, 1952.From the Departments of Medicine and Pathology, Veterans Administration Hospital, Oakland, California. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMitral valve prolapse in patients with prior rheumatic fever.Clinical Examination and Investigation of the HeartBibliographyAn Unusual Form of Mitral Valve Insufficiency Simulating Aortic StenosisMITRAL VALVE REPLACEMENT IN CHILDRENMurmurs of aortic stenosis and mitral insufficiency masquerading as one anotherAuscultatory and phonocardiographic manifestations of pure mitral regurgitationElectrocardiographic analysis of pure mitral valvular disease: A study based on fifty-seven cases with open-heart operationRelatively Benign "Pure" Mitral Regurgitation of Rheumatic Origin 1 May 1953Volume 38, Issue 5Page: 981-1001KeywordsArmed forcesCardiovascular therapyHospital medicineMitral insufficiencySystolic ejection murmur Issue Published: 1 May 1953 PDF DownloadLoading ...