Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 25-year-old quadriplegic man with mitral leaflet prolapse syndrome was seen for complaints of intermittent fever, chills, and cough of three months' duration. Subacute bacterial endocarditis was diagnosed. Unusual complications of this disorder included hyperplenism with pancytopenia, pericardial effusion, and multiple infections in the blood and the spleen. Antibiotic therapy was begun, and splenectomy was performed. After seven weeks of treatment, the patient was free of symptoms and was discharged with advice on appropriate antibiotic prophylaxis. We believe that although bacterial endocarditis is a major complication of mitral leaflet prolapse syndrome, it can be prevented with antibiotic prophylaxis whenever dental, surgical, or other invasive procedures are performed.
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PMID:Bacterial endocarditis in mitral leaflet prolapse syndrome. 707 Oct 31

Five patients with tetralogy of Fallot associated with aortic insufficiency were studied. They ranged from 6 to 34 years old (mean, 14 years), and 2 patients had a history of subacute bacterial endocarditis. Four patients had a bulboventricular type of ventricular septal defect. Prolapse of the right coronary cusp was the main cause of aortic insufficiency. Deformed valve secondary to subacute bacterial endocarditis and severe dilatation of the aortic annulus were the other causes. In addition to repair of the tetralogy defect, aortic valvuloplasty was performed in 2 patients. In the remaining 3 patients, the ventricular septal defect was closed with a relatively small-sized patch and no aortotomy was made. Four patients survived the operation, and no residual aortic insufficiency was observed in 3 of them. The etiology and the method of operation are discussed.
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PMID:Tetralogy of Fallot associated with aortic insufficiency. 738 46

The many changes in classification of cardiovascular disease during the twentieth century reflect changing etiology of diseases, clinical comprehension and technological advances. In particular, the etiology of valvular heart disease has changed dramatically in the last five decades. The significant reduction of acute rheumatic fever and its sequelae, and the recognition of non-rheumatic causes of valvular disease are responsible for the metamorphosis in the etiology of valvular disorders. Valvular heart disease can be classified as follows: 1) Heritable-congenital causes of valvular heart disease e.g., floppy mitral valve with mitral valve prolapse, bicuspid aortic valve, and the Marfan syndrome; 2) Inflammatory-immunologic causes such as rheumatic fever, acquired immune deficiency syndrome, endocardial proliferative disorders, and antiphospolipid syndrome; 3) Myocardial dysfunction-ischemic cardiomyopathy, dilated or hypertrophic cardiomyopathy-resulting in valvular heart disease; 4) Diseases and disorders of other organs as causes of valvular heart disease, e.g., chronic renal failure and carcinoid heart disease; 5) Valvular heart disease related to aging: calcific aortic stenosis and mitral annular calcification; 6) Valvular disease following interventions such as valvuloplasty, valve reconstructive surgery and valve replacement; and 7) Valvular disease related to drugs and physical agents, such as chronic ergotamine use, radiation therapy and trauma. In clinical practice the most common causes of mitral regurgitation are floppy mitral valve with mitral valve prolapse, ischemic heart disease, dilated cardiomyopathy and mitral annular calcification, while the most common cause of mitral stenosis is rheumatic fever. The most common causes of isolated aortic regurgitation are bicuspid aortic valve and floppy aortic valve, while the most common causes of isolated aortic stenosis are related to the bicuspid aortic valve and the development of calcific senile aortic stenosis. The most common causes of tricuspid regurgitation are dilated cardiomyopathy, ischemic cardiomyopathy, floppy tricuspid valve with tricuspid valve prolapse and infectious endocarditis. Combined mitral and tricuspid regurgitation occur with heritable connective tissue disorders, dilated or ischemic cardiomyopathy, while the most common cause of mitral stenosis plus aortic regurgitation is rheumatic fever. Statistics obtained from cardiac surgery and necropsy may underestimate the true incidence of certain valvular diseases by selection bias. This is particularly so with valvular disease associated with significant ventricular dysfunction, or in the elderly who may not be surgical candidates, or in cases where the valvular disease is not severe enough to require surgical intervention. Recent advances in hemodynamic and imaging technology allow clinicians to define valvular structure and function and to accurately classify valvular heart disease in clinical practice.
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PMID:Valvular heart disease: the influence of changing etiology on nosology. 800 Jun 16

Limitations in the long-term results of medical treatment for mitral regurgitation are well recognized, but the advances in its surgical repair have produced good results. Therefore, early surgical intervention has been the focus of treatment in Europe and America. Increased surgical intervention depends on the development of technical skills in mitral reconstruction. This study investigated presurgical factors making surgical reconstruction difficult in 103 patients who underwent mitral operations performed from April 1994 to September 1997 in our hospital. Records were reviewed retrospectively for etiology, type of operation, and the immediate result of operation. The etiology of mitral regurgitation was prolapse in 65 patients (63%), restriction in 14, normal in 11, infectious endocarditis in 10, and others in 3. The type of prolapse involved the anterior leaflet in 22 patients (34%), posterior in 28 (43%), and both leaflets in 15 (23%). Valve repair was attempted in 74 patients, of which 16 were switched to valve replacement during operation. These included anterior leaflet prolapse in 9 patients, posterior leaflet in 1, both leaflets in 3, restriction in 2 and infectious endocarditis in 1. The success rate for reconstruction of anterior leaflet prolapse was not high. The cause of mitral regurgitation was mostly prolapse of the mitral valve, in our country as well as in Europe and America. Prolapsed posterior leaflet is much more common in Europe and America, and there is a high success rate reported for its valve reconstruction. In contrast, this study cannot recommend earlier surgical intervention because of difficult repair for anterior leaflet prolapse.
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PMID:[Troublesome factors in mitral valve repair for mitral valve regurgitation]. 1064 29

Echocardiographic examination of 41 patients has demonstrated that mitral prolapse (MP) of the 1st and 2nd degree is frequently associated with latent or apparent hypothyroidism and occasionally with prolapse of the tricuspid and/or aortic valve. As a rule, MP has a silent course without regurgitation and is diagnosed at ultrasonography. Its correction is made by replacement with thyroid hormones. Beta-adrenoblockers for MP treatment are contraindicated in hypothyroidism. MP complications (sudden death, thromboembolism, infectious endocarditis) are rare in patients with hypothyroidism. Thyroid insufficiency sometimes is accompanied with hydropericardium which is symptomless and is detected only at echocardiography.
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PMID:[Echocardiographic evidence of heart state in patients with hypothyreosis]. 1069 70

Mitral valve prolapse has previously been found to be associated with severe cardiovascular complications such as embolic insults, infectious endocarditis, and sudden cardiac death. However, at the same time, in particular after adopting M-mode and 2D echo for diagnosis, prevalence of the disease was found to be very high, especially in the young. The dilemma of a disease which is frequent and mostly asymptomatic, but in some cases has catastrophic complications, has been solved by implementation of more restrictive diagnostic criteria based on an appreciation of the spatial morphology of the mitral annulus. These criteria call for diagnosis exclusively based on long axis views and a prolapse of > 2 mm beyond a line connecting the leaflet insertion points. "Classic prolapse" additionally requires diastolic thickness of the mitral leaflets of at least 5 mm. Two recent studies, a population-based study of mitral valve prolapse prevalence, and a case-control study of juvenile stroke patients compared to a group of young patients without a history of stroke, shed further light on this disease. The authors found that prevalence of mitral valve prolapse in an average population is 2-3% (1.3% for classic prolapse), without age or sex preponderance; the rate of cerebrovascular insults, congestive heart failure, and atrial fibrillation of patients with prolapse does not exceed that of the rest of the population; however, mitral insufficiency is more frequent; young patients with a history of cerebrovascular insult do not have higher mitral valve prolapse rates than young patients without previous insult.
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PMID:[Mitral valve prolapse]. 1086 10


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