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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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 sex-matched 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 of 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.
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PMID:Mitral valve prolapse in anxiety neurosis (panic disorder). 740

Within one and a half year 24 patients with arrhythmias or chest pain were investigated to detect a mitral valve prolapse syndrome which was found in 9 cases by echocardiography. Within this group 6 patients complained of fatigue, dizziness, dyspnea or syncope, 6 had chest pain, 7 paroxysmal tachycardia and 2 patients premature beats. Auscultation revealed in 3 cases a systolic click, in 1 case a systolic click with late systolic murmur and in 5 cases a systolic murmur only. The ECG showed premature ventricular contractions in 2 patients, ST-T abnormalities in 6 patients. Echocardiography showed a late systolic prolapse in 6 and a pansystolic prolapse in 3 patients. In 3 cases also an angiography was performed and in this way a mitral valve prolapse detected; hemodynamics and coronary arteries were normal in all 3 cases but in one case a mitral insufficiency and in one case an asynergy of the anterior wall was found. Pathophysiology, clinical symptoms and phonocardiographic, echocardiographic and angiographic findings in mitral valve prolapse syndrome are discussed.
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PMID:[Mitral valve prolapse syndrome]. 744 4

Since 1988 to 1992 we analyzed 116,452 consecutive 12-lead electrocardiograms belonging to the entire cohort of 18-year old young boys resident in Padova, Treviso, Rovigo, Venezia, Belluno area (2,834,000 inhabitants). We identified 173 cases of overt WPW pattern (short PR interval, delta wave, anomalous configuration of QRS complex) with a calculated incidence of 1.48/1000. Accessory pathway location was: left free wall (70 patients), right free wall (39 patients), postero-septal (37 patients), antero-septal (15 patients) and undetermined (12 patients). Sixty patients (34.6%) complained of different symptoms as palpitations, near syncope and dizziness. Fifty-three patients (30.6%) went in a regular sport activity. Twenty-four hour Holter monitoring (41 patients) and exercise stress test (43 patients) did not show sustained tachyarrhythmias; intermittent preexcitation was recorded in 23 and 32 patients, respectively. Two-dimensional echocardiogram (68 out of 173) was normal in 44 patients, while 24 showed minor cardiac abnormalities with two major disease; mitral valve prolapse was diagnosed in 8 patients. On the basis of transesophageal (24 patients) or intracardiac (5 patients) electrophysiologic study, 11 patients were considered at high risk for sudden death. Eight of them suffered from spontaneous symptoms.
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PMID:[The prevalence of the Wolff-Parkinson-White syndrome in a population of 116,542 young males]. 764 16

In recent years research has shown that subsets of patients with mitral valve prolapse also have associated autonomic or neuroendocrine dysfunction that can result in a number of related symptoms, including fatigue, palpitations, chest pain, exercise intolerance, dyspnea, dizziness, headache, sleep disorders, gastrointestinal disturbances, cold extremities, and panic attacks. These patients have been classified as having mitral valve prolapse syndrome. This article discusses the pathogenesis and management of mitral valve prolapse syndrome and serves to make clinicians aware of newer developments in the study of autonomic function and dysfunction.
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PMID:The phenomenon of dysautonomia and mitral valve prolapse. 800 50

The aim of the study was to analyse rhythm disturbances in 92 patients with mitral valve prolapse syndrome (52 women and 40 men). The patients were examined by resting electrocardiograms monitoring, exercise electrocardiogram (submaximal exercise test), phonocardiograms and echocardiograms. We found tachycardia sinusalis in 72 patients (78%), supraventricular premature beats in 23 (25%) and ventricular premature beats in 54 patients (59%). There was no correlation between dizziness and syncope and ventricular rhythm disturbances in those patients.
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PMID:[Arrhythmias in patients with mitral valve prolapse]. 858 29

Prolapsed mitral valve prolapse (PMV) is classically associated with disorders of ventricular excitability whose significance is unclear. However, syncope can suggest the possibility of a serious ventricular arrhythmia. The objective of this study was to try to identify the mechanisms of dizziness and syncope associated with PMV. We report the results of programmed atrial and ventricular stimulation performed under baseline conditions and after administration of Isuprel in 56 patients with PMV: 27 patients had a history of presyncope or syncope (group I), 14 had spontaneous atrial or supraventricular tachycardias without dizziness or syncope (group II) and 15 were asymptomatic and investigated for VEBs or conduction disorders (group III). The following results were obtained: In group I, 6 patients experienced sustained inducible ventricular tachycardia (VT); an atrial tachycardia (atrial tachycardia and/or atrial fibrillation) (AT) was also induced in 5 of them. In another 19 patients, a supraventricular tachycardia (SVT) and/or AT was induced. A total of 24 atrial or junctional tachycardias were triggered in this group. In group II, AT and/or SVT were reproduced in 13 out of 14 cases (93%). In group III, AT was triggered in 3 patients (20%). SVT were induced by Isuprel while AT were triggered prior to administration of Isuprel, under baseline conditions, and 3 of them were reproduced during vagal manoeuvres. A ventricular arrhythmogenic effect was observed in two cases in group II while taking class I antiarrhythmics. In conclusion, spontaneous AT and SVT of PMV are easily inducible with a sensitivity of 93%, but are difficult to induce in asymptomatic subjects. The high incidence of TA and SVT in the case of unexplained presyncope in subjects without documented tachycardia therefore appears to be suggestive of a relationship between these presyncopes and AT or SVT. However, the search for VT should take precedence. SVT appear to be catecholaminergic while AT tend to be vagal.
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PMID:[Syncopes associated with mitral valve prolapse. Mechanisms]. 876 45

A syndrome of acute pulmonary edema has been previously reported among scuba divers in cold, European waters. Because of the temperatures involved, the name "cold-induced pulmonary edema" was coined in the original 1989 description. We report six individuals who developed the identical syndrome, five while diving in Puget Sound and one in the Gulf of Mexico. The four women and two men ranged in age from 24 to 60 yr. They experienced one to six episodes apiece, each with the development severe dyspnea at depth without excessive exertion. Associated symptoms included cough, weakness, expectoration of froth, chest discomfort, orthopnea, wheezing, hemoptysis, and dizziness. Emergency medical evaluation of four divers revealed rales on examination and pulmonary edema on chest radiograph. In one diver with pulmonary edema on chest radiograph, pulmonary capillary wedge pressure was normal when measured acutely. Symptoms resolved either spontaneously over 1-2 days or with standard medial treatment for pulmonary edema. Prior history of cardiovascular disease was negative except for hypertension and mitral valve prolapse in one diver. Cardiac evaluations following recovery from the acute episodes were normal. Episodes in the cold waters of Puget Sound sometimes occurred despite the use of dry suits. Furthermore, one diver developed recurrent episodes in 27 degrees C water off Cozumel, Mexico. Development of pulmonary edema while scuba diving constitutes a distinct clinical entity which may occur in either "cold" or "warm" water. It is not associated with a decompression mechanism. Personnel caring for divers should be aware of the syndrome in order to provide optimal medical management.
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PMID:Pulmonary edema of scuba divers. 906 53

The authors studied the prevalence of mitral valve prolapse (MVP) in the group of 656 children and adolescents (329 males and 327 females), who were a representative sample (obtained with the Monte Carlo method of statistical trials) of all newborns in the city of Maribor, Republic of Slovenia, in the period of 18 years (1976-1992). The results were considered positive in children and adolescents who in addition to possible history (chest pain, palpitations, dizziness, loss of consciousness, headaches, perspiration), probable auscultatory finding (mezzosystolic click and late systolic murmur), and suspected phonocardiographic and ECG findings, also had a positive M-mode echocardiographic finding. The criteria for MVP on M-mode echocardiography were taken from the literature: descending of mitral cusp, either anterior or posterior, of at least 3 mm below the line connecting points C and D. Children and adolescents were divided into six age groups (infants, toddlers, preschool children, early school age, children in puberty, adolescents). Assuming MVP as a cause of cardiac arrhythmias, beside standard ECG we also performed holter ECG monitoring in 61 children and adolescents (29 with MVP, 32 without MVP). The results were tested with standard statistical tools (chi 2-test, Student t-test, 2 x 2 Fisher chi 2-test). MVP was found in 71 patients (10.8%, 32 males and 39 females). As regards age and sex we found lower prevalence of MVP in male children (9.7%) compared to female children (11.9%). The highest prevalence was found in early school age, more so in females (14.2 vs 13.7). The differences were not statistically significant (p > 0.05). In both sexes most frequent was endosystolic prolapse (males 59.3%, females 51.3%). Most commonly both cusps are involved in the prolapse (males 78.1%, females 66.7%). Most frequently measured descending of the cusps was 3-4.5 mm (males 56.2%, females 48.7%). Negative auscultatory finding (silent MVP) was detected in 47.8% of the patients with MVP. Most patients with diagnosed MVP had no symptoms (71.8%). The prevalence of asymptomatic MVP declines with age in both sexes. The prevalence of arrhythmias, both in standard ECG and holter ECG, is higher in patients with MVP (6.8:0%--NS and 44.6%:9.3%--p < 0.05). The influence of constitutional changes (dolichostenomelia, asthenic constitution, genua valga) on the appearance of MVP is reflected in statistically significant difference in the Rohr' index in the group of patients with MVP in relation to the healthy group (p < 0.05). The higher prevalence of headache and dizziness in the group with MVP is statistically significant (p < 0.05).
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PMID:[The mitral valve prolapse syndrome in children and adolescents]. 991 77

Mitral valve prolapse (MVP), is the most frequent valvulopathy, although it is difficult to evaluate its incidence since this pathology is often asymptomatic. However, in some patients a rich variety of symptoms such as chest pain, dyspnea, palpitations, syncope, dizziness, panic attacks and autonomic dysfunctions have been found. The pathogenesis of these symptoms, incompletely understood, appears to be multifactorial, related to altered autonomic function, adrenergic responsiveness and to combinations of these factors. In patients with MVP a variety of neuroendocrine anomalies has been found: high epinephrine and norepinephrine plasma levels, altered rennin-angiotensin-aldosteron (RAA) response to volume depletion and orthostatic stimulation, and high plasma levels of atrial natriuretic factor (ANF) especially in hypovolaemic individuals. The role of ANF could be important in the genesis of MVP syndrome, it could contribute to determine: the imbalance between the sympathetic and parasympathetic system, the altered RAA response to orthostatic stimulus, the volemic and venous flow reductions (with a direct action, other than diuretic and natriuretic action). Factors that can determine ANF secretion abnormality in MVP could be: 1) Mitral regurgitation; 2) increased heart rate and the high incidence, in MVP syndrome, of arrhythmias; 3) central nervous system neuroendocrine imbalance; 4) increased catecholamines secretion.
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PMID:Atrial natriuretic factor and mitral valve prolapse syndrome. 1153 51

Although several investigations on mitral valve prolapse syndrome (MVPS) have been performed, clinical symptoms of this syndrome are not yet clarified. Atypical chest pain, palpitations, fatigue, dyspnea and anxiety are the most frequent symptoms associated with this syndrome. However, dizziness and syncope may be serious symptoms in MVPS. Dizziness and syncope are related to cardiac arrhythmias and are proposed to distinguish types, frequency of arrhythmias and relation to the symptoms. Orthostatic hypotension and tachycardia rarely occur in MVPS. The physiopathological mechanisms of these symptoms are not known clearly, but multifactorial causes are thought to be responsible including autonomic dysfunction, hyperadrenergic state, abnormalities in regulation of baroreceptors, parasympathetic derangements, decrease of intravascular volume, abnormal renin-aldosterone response to depletion of intravascular volume and abnormal release of atrial natriuretic factor.
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PMID:[Mitral valve prolapse syndrome: orthostatic hypotension and physiopathology of its clinical symptomathologies]. 1262 13


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