Cardiovascular Medicine Book

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Mitral Valve ProlapseAka: MVP

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  1. Epidemiology
    1. Incidence: 2.4%
  2. Pathophysiology
    1. Redundant valve tissue with elongated chordae tendineae
  3. Symptoms
    1. Chest Pain (occurs in 50% of those with MVP)
      1. Prolonged, sharp and non-exertional
      2. May mimic Angina
    2. Vague associated symptoms
      1. Palpitations
      2. Weakness
    3. Red Flags for problems associated with MVP
      1. Exertional Syncope
      2. Family History of Sudden Cardiac Death
      3. Arrhythmia with Exercise
      4. Marked Mitral Regurgitation
  4. Signs
    1. Midsystolic click
      1. Results from sudden tensing of mitral valve
      2. Occurs as leaflets prolapse into left atrium
    2. Systolic Murmur
      1. Late systolic or holosystolic murmur
      2. Murmur prolonged with Valsalva
      3. Murmur decreased with squatting
    3. Timing of click and murmur
      1. Decreased end-diastolic volume (Standing)
        1. Click and murmur start just after S1 Heart Sound
      2. Increased end-diastolic volume (Squatting)
        1. Click and murmur start closer to S2 Heart Sound
  5. Diagnosis
    1. Electrocardiogram often abnormal
      1. Inverted T Waves in leads II, III, and AVF
    2. Holter Monitor
      1. Variety of dysrhythmias
    3. Echocardiogram
      1. Mitral Valve Prolapse is a common echo finding
      2. New criteria based on three dimensional valve shape
  6. Management
    1. Reassurance
      1. Low Incidence of serious complications
    2. Symptomatic treatment
      1. Indications
        1. Chest Pain
        2. Palpitations
        3. Anxiety
      2. Medications
        1. Beta Blockers
    3. General measures
      1. Alcohol cessation
      2. Tobacco Cessation
      3. Caffeine cessation
    4. SBE Prophylaxis
      1. Indicated only if Mitral Regurgitation present
  7. References
    1. Kondos (1998) CMEA Medicine Review Lecture, San Diego
    2. Assi (1998) Postgrad Med 104(6):99
    3. Bonow (1998) Circulation 98:1949
    4. Carabello (1997) N Engl J Med 337(1):32
    5. Joy (1996) Physician and Sportsmed 24(7):78-86
    6. Shipton (2001) Am Fam Physician 63(11):2201

Mitral Valve Prolapse (C0026267)

Definition (MSH)Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.
Definition (NCI)Prolapse of the mitral valve, often with regurgitation, associated with myxomatous proliferation of the leaflets of the mitral valve.
Definition (NCI)A fairly common and often benign valvular heart disorder characterized by redundancy or hooding of mitral valve leaflets so that they prolapse into the left atrium, often causing mitral regurgitation. It is often a symptomless condition but may be marked by varied symptoms (e.g. chest pain, fatigue, dizziness, dyspnea, or palpitations) leading in some cases to endocarditis or ventricular tachycardia.
ConceptsDisease or Syndrome (T047)
EnglishAsynchronous valve closure syndrome, BARLOW SYNDROME, Barlow's syndrome, BARLOWS SYNDROME, Click syndrome, CLICK-MURMUR SYNDROME, Floppy Mitral Valve, Floppy Mitral Valves, Floppy valve syndrome, IRRITABLE HEART, J.B. Barlow's syndrome, Mitral Click Murmur Syndrome, Mitral Click-Murmur Syndrome, Mitral regurgitation due to cusp prolapse, Mitral valve posterior leaflet prolapse, Mitral Valve Prolapse, MITRAL VALVE PROLAPSE SYNDROME, Mitral Valve Prolapses, MVP, MVP - Mitral valve prolapse, NEUROCIRCULATORY ASTHENIA, ORTHOSTATIC INTOLERANCE, PMV, PROLAPSED MITRAL VALVE, SOLDIERS HEART, Systolic Click Murmur Syndrome, Systolic Click-Murmur Syndrome, SYSTOLIC MURMUR-CLICK SYNDROME
Spanishprolapso de la valvula mitral, prolapso mitral, sindrome de J.B. Barlow, sindrome del cierre valvular asincronico
Parent ConceptsHeart Valve Prolapse (C0079485), Valvular Heart Disorder (C1710615), Diseases of mitral valve (C0026265), Mitral cusp prolapse (C0344407), Ambiguous concept (C1274012)
SourcesCOSTAR, CSP, DXP, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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