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

Heart disease is the most important nonobstetric cause of maternal death; however, most young women with heart disease do well during pregnancy. If the physician is uncertain of the effects of pregnancy on a particular heart condition, needless restrictions may be imposed. The main hazards are: pulmonary edema when it occurs suddenly in mitral stenosis; pulmonary hypertension (because pulmonary vascular disease tends to be exacerbated by pregnancy); infective endocarditis (this is rare); and fulminating peripartum cardiomyopathy. The practical management of the pregnant patient with various concomitant heart conditions (congenital heart disease, pulmonary hypertension, rheumatic heart disease, anticoagulants and artificial valves, constrictive pericarditis, kyphoscoliosis, Marfan's syndrome, mitral prolapse, hypertrophic cardiomyopathy, dilated cardiomyopathy, infective endocarditis, and arrhythmias) is discussed. An absolute indication for therapeutic abortion is severe pulmonary vascular disease; discretionary indications include 'chronic thromboembolic pulmonary hypertension,' cardiomyopathies (depending on the hemodynamic disturbance), and Marfan's syndrome.
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PMID:Cardiovascular disease in pregnancy. 218 16

The usefulness of pacemaker treatment appears doubtful in patients suffering from syncope of unknown origin after a complete diagnostic evaluation, which includes electrophysiological study. To better assess the effectiveness of this therapy, 24 patients with syncope of unknown origin and negative electrophysiological study were prospectively and alternatively assigned to treatment with pacemaker (group A) vs treatment without pacemaker (group B). Group A included 12 patients (7 males, 5 females) with a mean age of 64 +/- 10 years. No heart disease was present in 7 cases (58%); 3 cases had chronic ischaemic heart disease (25%) and 2 had hypertensive heart disease (17%). The standard ECG was normal in 7 patients, while various conduction abnormalities were observed in the other 5. The mean number of syncopal episodes was 4.8 +/- 3.9 per patient, and the mean between the onset of symptoms and the beginning of this study was 32 +/- 42 months. In these 12 cases a VVI-M pacemaker was implanted, at a programmed rate of 50 or 60 bpm; in three subjects, the pacemaker was of the diagnostic type ("bradycardia event counter"). Group B included 12 patients (8 females, 4 males) with a mean age of 56 +/- 11 years. Organic heart disease was absent in 7 cases (58%); 4 patients showed hypertensive heart disease (33%) and 1 had mitral prolapse (9%). The ECG was normal in 9 subjects. The mean number of syncopes was 3.2 +/- 1.5 per patient; the mean interval since the onset of symptoms was 18 +/- 19 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Syncope of unknown origin after electrophysiologic study: is the treatment with pacemaker useful?]. 218 56

Since 1977, six patients (five males and one female), aged 14 to 35 years, resuscitated from ventricular fibrillation, were referred to our department for detailed evaluation, after exclusion of major cardiac pathologic conditions. Four patients had a family history of heart disease. Basic ECGs showed sinus rhythm in all of them. PR interval was prolonged in one. Two patients had complete and one had incomplete right bundle branch block. One patient had inverted t waves in V1-3 and late potentials. Three had an upsloping ST-T segment elevation in V1-2. The cardiothoracic index was less than 0.5 in five and 0.50 in one. In one of the five patients studied, the clinical episode of ventricular fibrillation was reproduced by stimulation of the right ventricular outflow tract during electrophysiologic study. Results of cross-sectional echocardiography and angiography showed predominantly structural and wall motion abnormalities of the right ventricle in five patients and slight wall motion abnormalities of the left ventricle in two. Two patients also had mitral and tricuspid valve prolapse. Coronary arteries were normal in all five patients examined. Results of endomyocardial biopsy showed no abnormalities in one patient, fibrosis in two, and fibrolipomatosis in one. Two patients died during follow-up: autopsy was performed in one and results showed right ventricular cardiomyopathy. Thus in five of these selected patients with apparent idiopathic ventricular fibrillation, some abnormalities, predominantly of the right ventricle, were documented only after detailed investigation; however, clinical history and some nonspecific ECG abnormalities were factors in the diagnostic procedure.
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PMID:Ventricular fibrillation without apparent heart disease: description of six cases. 258 61

The authors studied the data of echocardiography performed at the district diagnostic center rendering services for 337000 adult population. Altogether 487 patients were referred to the center for echocardiography. The main portion of the patients included 398 persons (81.7%) with suspected heart disease and prolapse of one of the cusps of the mitral valve. 326 persons (66.7%) were under 39 years. The experience in the use of echocardiography under the conditions of the specialized polyclinics (the diagnostic center) has shown the high efficacy of the technique during examination of the patients at the prehospital stage.
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PMID:[Experience in using echocardiography at a district diagnostic center]. 259 95

Marked clinical or electrocardiographic changes, suggestive of heart disease, were only detected in 14 (7%) of 190 patients with sarcoidosis. Diffuse myocardial accumulation of 99mTc pyrophosphate (2+ or 3+) was seen in 12 (43%) of 28 patients with active sarcoidosis. Repeated scintigraphy showed normal values in 3 patients after a course of corticosteroid therapy. Echocardiographic signs of heart disease were found in 33 (37%) of 89 patients, including left-ventricular contractility disorders in 21, thinning (5) or thickening (7) of left-ventricular wall and ventricular septum, mitral prolapse in 3 and limited pericardial exudate in 5. Signs of pulmonary heart were detected in 17 patients. Clinical and electrocardiographic symptoms of cardiac sarcoidosis were significantly more frequent in patients with myocardial Tc-pyrophosphate accumulation and echocardiographic changes. It is suggested that myocardial Tc-pyrophosphate scintigraphy and echocardiography may be used for the diagnosis of cardiac sarcoidosis, including its latent forms.
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PMID:[Current methods of examination in the diagnosis of sarcoidosis of the heart]. 285 Mar 92

The study was performed in 33 patients with echocardiographic diagnosis of mitral valve prolapse (PVM), without any other associated heart disease. A 19 derivations electrocardiogram (ECG) was performed a direct inscription 4 channel Samborns 150 machine at 25 and 50 mm/sec. The purpose of the study was determine the alterations in ventricular depolarization and repolarization, and to correlate them with valve prolapse, as well as with cavitary and parietal dimensions, as measured by M mode and/or two-dimensional echocardiography. Left ventricular hypertrophy detected by ECG agreed with the ECO test in 77%; the sensitivity was of 86% and specificity of 67.5%. Left ventricular hypertrophy detected by ECG was not related with the type of prolapse. Ventricular repolarization alteration was very frequent (84.8%). Association of this parameter with initial notch of R in a VF becomes important for diagnosis suspicion (p less than 0.01). When the abnormal repolarization affected the anterolateral wall, posterior valve prolapse was frequent; when the posteroinferior region was the affected one, the prolapse occurred more frequently in both valves. An important correlation (p less than 0.01) was found between left ventricular dilatation detected by ECO and the abnormal ventricular repolarization.
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PMID:[Electro-echocardiographic correlation in mitral valve prolapse]. 295 79

In order to study the etiologies and mechanisms in sports-related sudden death, the author selected 198 cases from the world literature which met the following criteria: subjects were less than 40 years of age and in good physical condition, death occurred at the latest 1 hour after the physical activity, there was no known heart disease, and an autopsy had been performed. In spite of the heterogeneous character of those subjects included in this study and numerous biases, the following results were obtained: in some cases, the mechanism underlying the sudden death could be confirmed by autopsy (massive myocardial infarction, rupture of the aorta, cerebral hemorrhage), and in others it appeared highly probable (atheromatous or congenital coronary artery lesions, hypertrophic cardiomyopathies). Finally, in a certain number of cases, the observed abnormalities could only be seen as presumptive evidence (mitral prolapse, sequelae of myocarditis, or the presence of toxic agents). Failure to establish a precise diagnosis at autopsy occurred in only 22 cases (11%), however, amphetamine drug presence was discovered in 7 of these cases. Approximately one-half of the group studied revealed atheromatous coronary artery lesions (29% of cases) or congenital lesions (17.5%) especially involving the origin of the left coronary artery. These were followed in frequency by the hypertrophic cardiomyopathies. Mitral valve prolapse and WPW syndrome were rarely encountered. Extracardiac causes included rupture of the aorta (4.5%) and cerebral vascular accidents (5%).
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PMID:[Sudden death in athletes]. 315 27

Mitral valve prolapse by current echocardiographic criteria can be diagnosed with surprising frequency in the general population, even when preselected normal subjects are examined. In most of these individuals, however, prolapse is present in the apical four chamber view and absent in roughly perpendicular long-axis views. Previous studies have shown that systolic annular nonplanarity can cause apparent prolapse in the four chamber view without actual leaflet displacement above the most superior points of the anulus, and there is evidence for such nonplanarity in vivo. It is then reasonable to ask whether superior leaflet displacement limited to the four chamber view has any pathologic significance or complications. The purpose of this study, therefore, was to address the following hypothesis: that patients with superior leaflet displacement confined to the four chamber view have no higher frequency of associated echocardiographic abnormalities than do patients without displacement in any view. Such abnormalities, which would provide independent evidence of mitral valve pathology or dysfunction, include leaflet thickening, left atrial enlargement and mitral regurgitation. Leaflet displacement was measured in the parasternal long-axis and apical four chamber views in 312 patients who were studied retrospectively and selected for the absence of forms of heart disease other than mitral valve prolapse. Leaflet thickness and left atrial size were measured and mitral regurgitation was graded. Patients with leaflet displacement limited to the four chamber view were no more likely to have associated abnormalities than were patients without displacement in any view (0 to 2% prevalence, p greater than 0.5). In contrast, patients with leaflet displacement in the long-axis view were significantly more likely to have associated abnormalities (12 to 24%, p less than 0.005), the frequency of which increased with the extent of leaflet displacement in that view (p less than 0.0001). These results suggest that displacement limited to the apical four chamber view is, in general, a normal geometric finding unassociated with echocardiographic evidence of pathologic significance.
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PMID:Reconsideration of echocardiographic standards for mitral valve prolapse: lack of association between leaflet displacement isolated to the apical four chamber view and independent echocardiographic evidence of abnormality. 328 89

In a retrospective ultrasonographic study, 32 cases of acquired disease of the tricuspid valve were detected amongst 7000 consecutive patients. Patients with congenital heart disease (except when the seat of an acquired disease) and with prosthetic heart valves, were excluded. There were twenty-one cases of rheumatic disease, all having additional involvement of the mitral valve. Prolapse (5 patients), bacterial endocarditis (2 patients), rupture of papillary muscle (1 patient), cardiac tumours (2 patients) and carcinoid heart disease (1 patient) were also identified. Acquired disease of the tricuspid valve is infrequently encountered during routine cross-sectional echocardiography but its recognition is clinically important.
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PMID:Acquired abnormalities of the tricuspid valve--an ultrasonographic study. 354 79

Mitral valve prolapse (MVP) has been reported to be the most common cardiac disorder in reproductive-age women. The purposes of this prospective investigation were to determine the effect of pregnancy on cardiac function in women thought to have MVP and to determine whether any such changes would adversely affect pregnancy outcome. During a recent three-year period, 43 (1.2%) of 3,582 pregnant women followed in our clinic had a prior diagnosis of MVP without any other cardiac disorder. On closer evaluation, only 21 women (0.6%) had a previous echocardiogram suggestive of MVP. Serial echocardiograms in these women revealed that pregnancy caused either no change or an improvement in the valve prolapse. No cardiac complications were present, and perinatal outcomes were favorable. MVP may be less pronounced during pregnancy, and an echocardiogram late in gestation seems worthwhile to confirm the diagnosis before delivery.
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PMID:Mitral valve prolapse. Echocardiographic changes during pregnancy. 357 98


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