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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aortic-mitral valve discontinuity has previously been described in double outlet right ventricle, endocardial cushion defect, single ventricle, tetralogy of Fallot, and prolapse of the mitral valve. We are reporting two additional examples of aortic-mitral valve discontinuity including 15 cases of gross left ventricular dilation and a case of acute pneumococcal bacterial endocarditis with a large subannular erosion. While nonspecific, aortic-mitral valve discontinuity is a clinically important sign that should be sought with slow-M-mode scanning and strip chart recording.
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PMID:Echocardiographic recognition of the mitral valve-posterior aortic wall relationship. 12 81

Systolic prolapse of the tricuspid valve is a relatively unknown anatomo-clinical entity. In this communication etiology, clinical significance and diagnostic problems of this condition are reported and discussed. The frequent association with mitral valve prolapse and the coexistence of skeletal and cardiac anomalies strongly suggest the role of congenital factors and the degenerative nature of this valvular abnormality. Pathophysiology of leaflets prolapse remains unexplained for those few reported cases of isolated tricuspid invovlement. The clinical diagnosis of tricuspid valve prolapse is difficult, since the characteristic physical signs of tricuspid incompetence are uncommon, while apical mid-systolic click-late systolic murmur may indicate mitral valve prolapse, tricuspid valve prolapse, or a combination of the two. In the reported cases selective right ventriculography (R.A.O.) has shown pansystolic or late systolic prolapse of anterior and inferior leaflets (without or with varying degree of tricuspid incompetence) or isolated late systolic prolapse of the inferior cusp. M-mode echocardiography has shown great value in the diagnosis of tricuspid valve prolapse. On the echocardiogram several types of abnormalities have been noted which correlated well to angiocardiographic data. Tricuspid valve prolapse is of clinical importance, since this condition may be associated with significant tricuspid incompetence, a high incidence of cardiac arrhythmias, and possibly with bacterial endocarditis.
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PMID:[The tricuspid valve prolapse. Clinical significance and diagnostic problems (author's transl)]. 45 98

We examined the natural history of mitral-valve prolapse in 53 patients who had had a midsystolic click or late systolic murmur (or both) documented phonocardiographically a mean of 13.7 years earlier. Thirty-eight patients were alive without serious complications, and seven had died of unrelated causes. In two patients prolapse was implicated in the cause of death. Other complications were ventricular fibrillation in one patient and bacterial endocarditis in three. Progressive mitral regurgitation developed in five patients, requiring valve replacement in two. These complications occurred in a total of eight patients (15 per cent), and were significantly (P = 0.15) associated with a late systolic murmur rather than an isolated midsystolic click. Thus it appears that the diagnosis of mitral-valve prolapse should not be regarded as ominous; however, patients in whom this diagnosis is associated with a late systolic murmur should be followed carefully.
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PMID:Long-term prognosis of mitral-valve prolapse. 86 49

A 53-year-old man had had recurrent episodes of transient visual loss, malaise and a heart murmur. Blood cultures repeatedly grew Pseudomonas maltophilia, a frequent opportunistic pathogen, and echocardiogram documented mitral-valve prolapse. The risk of bacterial endocarditis is stressed.
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PMID:Pseudomonas maltophilia bacteremia associated with a prolapsed mitral valve. 87 7

The echocardiographic findings in 12 patients with tricuspid valve prolapse are presented. Eight of these patients had associated mitral valve prolapse. Only one of the above patients had the characteristic physical signs of tricuspid incompetence. Two types of abnormality were noted on the echocardiogram of the tricuspid valve. In eight patients, the systolic segment of the tricuspid valve showed an initial horizontal motion followed by a posterior motion in midsystole. Four patients exhibited posterior motion of the tricuspid valve in early systole, which reached a maximum in midsystole, and this was followed by an anterior motion, thus producing a hammock-like configuration. We conclude that echocardiography is useful in the diagnosis of tricuspid valve prolapse. Since this condition may be associated with clinically significant tricuspid incompetence or bacterial endocarditis, its recognition is of clinical importance.
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PMID:Echocardiographic detection of tricuspid valve prolapse. 112 85

Forty-seven echocardiograms were obtained in 32 patients with bacterial endocarditis. Preexistent abnormalities were found in 14 patients. In five of them thought to have bacterial endocarditis on normal valves, echocardiography showed mitral stenosis (one), bicuspid aortic valve (two), and prolapse of mitral valve (two). Definite vegetations were seen in 22 patients--on the aortic valve in seven, the mitral valve in 12, and both valves in three. Ten patients had milder changes suggestive but not diagnostic of vegetations. In 12 patients, surgery confirmed the echocardiographic findings. Fourteen had systemic embolic episodes and all had echocardiographic evidence of vegetations. Abnormalities secondary to bacterial endocarditis, other than vegetations, were common. Twenty-one patients had left ventricular volume overload. Ten had a flail posterior leaflet of the mitral valve, three of which were confirmed surgically. Eight had abnormal coarsely fluttering echoes in the left ventricular outflow tract consistent with a prolapsing aortic valve or underlying aortic vegetations; four were confirmed by surgery. Five had signs of severe aortic regurgitation of recent onset (premature mitral valve closure) and all had confirmation by surgery. Echocardiographic abnormalities persisted after successful medical treatment. We conclude that echocardiography is helpful in patients with bacterial endocarditis. It permits recognition of unsuspected preexistent lesions and the characteristic vegetations, as well as the extent and nature of valvular damage secondary to bacterial endocarditis. However, echocardiography does not differentiate between active and healed lesions.
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PMID:Spectrum of echocardiographic findings in bacterial endocarditis. 124 79

In a population-based study of 41 children with bacterial endocarditis (BE), diagnosed in the period 1970 through 1989 in eastern Denmark, we analyzed trends in the diagnosis of BE and in mortality, and searched for possible prognostic factors. During this period the delay in diagnosis from first symptom to treatment did not change, but the delay from admission to treatment was significantly prolonged from 0 to 3 days, despite the introduction of echocardiography (ECHO). There was a significant improvement in the prognosis, the mortality rate having decreased from 40 to 0% [95% confidence limits: 12-74 vs. 0-26 (0.01 less than p less than 0.02)]. The improved prognosis was not explained by changes in the etiology or pattern of antibiotic resistance and may reflect a milder course of BE in children. Children with "mild anomalies"--such as bicuspid aortic valve (n = 5), coarctation of the aorta (n = 2), and prolapse of the mitral valve (n = 2)--had a significantly poorer prognosis than children with other forms of congenital heart disease (CHD) (p = 0.004), a reminder of the importance of suspecting BE in all children with unexplained long-lasting or intermittent fever, because some may have unrecognized "mild" CHD.
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PMID:Bacterial endocarditis in children: trends in its diagnosis, course, and prognosis. 151 37

Mitral valve prolapse is found in 2-5% of the whole population and is thus the most common valvular anomaly. The vast majority of patients are asymptomatic and remain free of complications during the follow-up. The most important complications are severe mitral regurgitation, bacterial endocarditis, cerebral ischemic stroke and arrhythmias. The risk of these complications is increased in patients with a holosystolic murmur, enlarged left atrium and/or ventricle, and redundant, thickened mitral leaflets. The complication rate increases with age and is generally higher in males. The risk of complications is very low in patients with an isolated systolic click or silent prolapse. Prophylactic treatment for endocarditis is recommended for patients with a systolic murmur. For patients surviving ischemic stroke, aspirin is recommended. Where the left atrium is enlarged and rhythm disturbances are present, anticoagulation treatment is preferable. Rhythm disturbances should be treated only when symptomatic. In cases of severe mitral regurgitation surgery should be considered early, since reconstruction of the valve can be achieved in the majority of patients.
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PMID:[Mitral valve prolapse--clinical significance of a frequent diagnosis]. 204 27

Infective endocarditis caused by Streptococcus suis serotype 2 is not uncommon in pigs but is rare in human beings. We describe the case of a pig-farmer with endocarditis due to S. suis serotype 2 and in whom prolapse of the mitral valve was the predisposing cardiac lesion. Streptococcus suis, a possible cause of infective endocarditis in endemic areas, may be confused with other group D streptococci. In suspected cases a history of contact with pigs or raw pork should be sought.
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PMID:Infective endocarditis caused by Streptococcus suis serotype 2. 223 Jan 81

A case of bacterial endocarditis caused by Enterobacter agglomerans was observed in a 50-year-old patient with mitral valve leaflet prolapse. The diagnosis was based on clinical findings, positive blood cultures and echocardiographic investigations.
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PMID:[Bacterial endocarditis caused by Enterobacter agglomerans in a patient with mitral valve prolapse]. 262 2


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