Most commonly idiopathic; may accompany rheumatic fever, ischemic heart disease, atrial septal defect, Marfan syndrome, Ehlers-Danlos syndrome.
Pathology
Redundant mitral valve tissue with myxedematous degeneration and elongated chordae tendineae.
Clinical Manifestations
More common in females. Most pts are asymptomatic and remain so. Most common symptoms are vague chest pain and supraventricular and ventricular arrhythmias. Most important complication is severe MR resulting in LV failure. Rarely, systemic emboli from platelet-fibrin deposits on valve. Sudden death is a very rare complication.
Physical Examination
Mid or late systolic click(s) followed by late systolic murmur at the apex; exaggeration by Valsalva maneuver, reduced by squatting and isometric exercise .
Echocardiogram
Shows posterior displacement of one or both mitral leaflets late in systole.
Mitral Valve Prolapse TREATMENT
Asymptomatic pts should be reassured. Beta blockers may lessen chest discomfort and palpitations. Prophylaxis for infective endocarditis is indicated only if prior history of endocarditis. Valve repair or replacement for pts with severe mitral regurgitation; aspirin or anticoagulants for pts with history of TIA or embolization.
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