MITRAL VALVE PROLAPSE:

• common cause of mild mitral regurgitation (congenital abnormality or degenerative myxomatous changes)

• common in women, who exhibits some features, such as sternal abnormalities, tall, thin stature

• may be inherited as an autosomal dominant phenotype

• symptoms - asymptomatic or associated with atypical chest pain, palpitations, anxiety, neuropsychiatric symptoms (neuroendocrine and autonomic disfunction occurs in some patients and may contribute to the symptoms)

• mitral valve usually is large, floppy, and redundant

• mid-systolic click - in the mildest forms (valve remain competent but bulges into the atrium during systole)

• the click is followed by a late systolic murmur in the presence of regurgitation (the murmurs lengthens as regurgitation becomes more severe)

• prolongation of chordae tendineae increase mitral regurgitation (chordal rupture - regurgitation becomes severe) - complications after fifth or sixth decade (loose myxomatous connective tissue, along with collagen dissolution

• increased incidence of arrhythmias (usually benign)

• haemodynamically significant mitral prolapse can predispose to infective endocarditis

• the long - term prognosis is good

Category: Cardiology Notes