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

This report reviews the clinical features of 80 patients with roentgenographically proved mitral annular calcification. The mean age of the group was 73 years, and there was a 2.5 to 1 female to male ratio. Evaluation for underlying cardiovascular disease revealed six patients with severe calcific valvular aortic stenosis; five patients with hypertrophic cardiomyopathy, 11 with mitral prolapse and 33 with significant arterial hypertension (blood pressure greater or equal to 150/96 mm Hg). Eighty-five per cent of the group (68 of 80 patients) had an underlying cardiac disorder associated with either chronically increased left ventricular systolic pressure or abnormal leaflet motion. Other cardiovascular abnormalities occurring as complications secondary to the mitral ring calcification included subacute bacterial endocarditis (three cases), arterial emboli (five episodes) and high grade atrioventricular block (16 cases). Twelve patients had severe mitral regurgitation; successful mitral valve replacement was carried out in four patients (all with myxomatous mitral tissue). Evidence of diffuse conduction system disease, not limited to the area of the cardiac fibrous skeleton, was found frequently (44 patients). Nine patients had sinus node dysfunction and 35 patients had electrocardiographic evidence of distal intraventricular (fascicular) block. Twenty-one patients eventually required pacemakers for management of symptomatic bradyarrhythmias. Atrial fibrillation was present in 23 patients. In this review it was found that calcification of the mitral annulus is frequently associated with or induces serious cardiovascular disease. Since some of these disorders may be modified by appropriate therapy, calcification of the mitral annulus should no longer be ignored as a benign marker of the elderly heart.
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PMID:Calcification of the mitral annulus: etiology, clinical associations, complications and therapy. 15 99

We believe there is a significant association between migraine and the prolapse mitral valve syndrome. Propranolol is the drug of choice in these patients for the treatment and prevention of migraine. Increased platelet aggregability may be the common pathophysiologic mechanism as relates to emboli from the valve and possibly in strokes related to migraine. Recognition of the association of the two syndromes will result in appropriate subacute bacterial endocarditis prophylaxis for patients at risk as well as prevention of improper medication to those patients with migraine who are at risk for stroke.
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PMID:Migraine and the mitral valve prolapse syndrome. 26 94

A patient with Marfan's syndrome and subacute bacterial endocarditis is presented. Echocardiographic studies demonstrated dilatation of the aortic root, prolapse of the posterior leaflet of the mitral valve, and the appearance of shaggy echoes on the anterior miltral leaflet, of the kind previously described as representing bacterial vegetations.
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PMID:Bacterial endocarditis in a patient with Marfan's syndrome. 100 Oct 61

Views regarding mitral valve prolapse, in particular its diagnosis and prognosis, have undergone great changes in recent years. The typical auscultation finding of a meso-systolic click and/or late systolic murmur is very specific for prolapse but it is not very sensitive. The basic diagnostic method of mitral valve prolapse is echocardiography. The non-realistic high prevalence of echocardiographic findings of prolapse in otherwise healthy subjects led recently to the introduction of stricter echocardiographic diagnostic criteria. The term mitral valve prolapse syndrome describes not confirmed association of anatomical valvular prolapse with non-specific symptoms of autonomous dysfunction. An attempt to explain non-specific complaints by an anatomical abnormality of the mitral valve has become very popular but, as increasingly apparent, is purely speculative. Controlled investigations provide evidence that the mitral valve prolapse syndrome does not exist that it is only an incidental coincidence of two conditions very frequently encountered in the population. The prognosis of the great majority of people with a mitral valve prolapse is very favourable. Only about 2-4% of subjects with prolapse are seriously threatened by complications such as infectious endocarditis, thromboembolic episodes, complex arrhythmias and sudden death. This small sub-group with a high risk is formed above all by patients with mitral insufficiency with severe haemodynamic impact. Independent negative prognostic signs are age above 50 years and male sex.
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PMID:[Changing views on mitral valve prolapse]. 152 65

The paper reports on 13 cases of infectious endocarditis in the patients with prolapse of the mitral valve admitted for a period of 10 years (1979-1989) into the Clinic of Cardiology of the Fundeni Hospital. These cases stand for 3.6% of the cases with prolapse of the mitral valve admitted during that period, and 5% of the patients with infectious endocarditis. Our study dealt only with the cases of the prolapse of the mitral valve, clinically and echographically documented before the appearance of the septic graft. The hemocultures were positive in all the patients (viridans streptococci in 84.61% cases). The symptomatology, the clinical objective data and the paraclinical results (phonocardiographic, echocardiographic, electrocardiographic, radiologic, investigations with isotopes), the response to the treatment (medical, surgical) and the evolution in time were analyzed. An increase was found during endocarditis in the number of patients with holosystolic murmurs (30.7% cases) versus those with click-telesystolic murmur, the appearance in 41.15% of the cases of valvular vegetations at the Echo examination, and in 15.38% cases of ruptures of cordages. Mitral insufficiency secondary to endocarditis became worse, in 30.76% cases. The treatment with antibiotics resulted in the healing of the infection in all the cases. The surgery was not necessary in any patient during the evolution of endocarditis. The surgery (valvular prosthesis) was made in 23.07% cases, which presented, after curing the septic graft, important mitral regurgitation with cardiac insufficiency refractory to the medical treatment. Prophylaxis of the infectious endocarditis in the prolapse of mitral valve with mitral regurgitation is necessary.
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PMID:[Infectious endocarditis in mitral valve prolapse]. 197 92

Secondary valve prolapse emerges in a variety of heart diseases: coronary heart disease, dilated and hypertrophic cardiomyopathies, acquired valvular heart disease, infectious endocarditis, pulmonary hypertension, etc. Valve prolapse results from dilation of valvular fibrous rings, dysfunction of papillary muscles, mitral lesions in valvulitides. Secondary valve prolapse in dilatation of valvular opening entails manifest disorders of systemic and intracardiac hemodynamics except for cases of aortic root dilatation. In decreased valvular opening secondary valve prolapse is not associated with considerable shifts in hemodynamics. Secondary valve prolapse suggests primary structural and functional defects in the heart rather than promotes the development of circulatory insufficiency.
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PMID:[Secondary prolapse of heart valves]. 237 Jul 83

A nineteen-year-old female who had history of infectious endocarditis underwent surgical repair for ruptured aneurysm of sinus of Valsalva with aortic regurgitation. Through aortotomy mild degree of prolapse of right coronary cusp and perforation of left coronary cusp sized 6 mm in diameter were recognized and the latter was thought to be the dominant lesion resulting in severe aortic regurgitation. Following direct closure of ruptured aneurysm and patch closure of ventricular septal defect, perforated left coronary cusp was repaired with autologous pericardium. Post operative course was uneventful and she is now doing well.
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PMID:[A case report of successful repair for ruptured aneurysm of sinus of Valsalva (I VSD) with aortic regurgitation]. 261 29

The clinical presentation, diagnosis, and surgical treatment of 63 patients with doubly committed subarterial ventricular septal defects (DCVSD) were analyzed retrospectively. The patients were divided into three groups. Thirty-one patients had severe congestive heart failure in infancy and presently have a large ventricular septal defect that has no tendency to close or to produce aortic valve regurgitation (Group 1). Ideally, these defects should be closed in infancy, and the transpulmonary approach is recommended to achieve closure. In the first group, there was one death in a patient with a hypoplastic right ventricle. In Group 2, nineteen patients had aortic valve prolapse or aortic valve regurgitation. The DCVSD were moderately large or small. A number of DCVSD in Group 2 patients had maintained the normal offsetting of the arterial valves. These defects must be closed by the time mild aortic valve regurgitation has occurred. In Group 2, there was one late death in a patient who developed subacute bacterial endocarditis. The two patients who had severe aortic valve regurgitation required aortic valve replacement and underwent multiple surgical procedures to replace calcified bioprostheses. Group 3 comprised 13 patients who were diagnosed with tetralogy of Fallot. All of these patients had a large DCVSD with aortic valve overriding. All Group 3 patients survived radical repair of the defect, which required a transannular patch in most cases (76%).
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PMID:Surgical management of doubly committed subarterial ventricular septal defects. 318 Apr 5

Surgically treated ventricular septal defect (VSD) was of supracristal type in 120 of 389 Chinese patients; 93 of the 120 were younger than 15 years. Concomitant aortic anomalies were present in 58 of the patients (regurgitation in 23 and cusp prolapse in 35). Corresponding figures among the 93 patients of the under-15 group were 40 (9 + 31). Direct suture or patch closure of the supracristal VSD and replacement or plication of anomalous aortic valves were the methods used. The results of direct closure were equal to those of patch closure. One patient died of subacute bacterial endocarditis, which had been present preoperatively. There were no other deaths. The postoperative observation period was 6 months to 7 years. As the incidence of associated valvulopathy increases with patient age, early operation for supracristal VSD, regardless of shunt volume, is advocated.
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PMID:Surgical treatment of supracristal type of ventricular septal defect. 322 24

Patients with congenital heart diseases (CHD), who had been under our management during school days (elementary, junior high and senior high schools), were followed up into early adulthood (20-38 years in age, averaging at 27.3 years) to obtain the following results. (1) The course of mild CHD until early adulthood was favorable in terms of fatality rate. However, the incidence of complication and resultant deterioration was higher in non-operated mild CHD cases than in operated CHD cases. Representative complications in mild ventricular septal defect (VSD) cases were infectious endocarditis and aortic incompetence (often found in type I VSD cases). A chief complication in mild atrial septal defect (ASD) cases was prolapse of the mitral valve. (2) Patients with VSD or PDA (particularly mild cases) showed spontaneous recovery even in early adulthood. (3) The prognosis of non-operated CHD cases of moderate or higher severity was evidently poor compared to that of mild or operated cases. These results suggest that surgery is indicated in all CHD cases of moderate or higher severity so long as surgery is possible.
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PMID:Follow-up study into early adulthood of patients with congenital heart diseases. 344 97


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