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

This report concerns 9 patients in whom rupture of the cordae of the mitral valve was suspected from the echocardiogram. The authors recall the clinical, echocardiographic, arteriographic, haemodynamic and anatomical findings in patients with rupture of the chordae; they emphasise the importance of echocardiograpy in the pre-operative diagnosis of this condition. In this series, the most frequent clinical sign was a loud pan-systolic murmur at the apex. The electrocardiographic abnormalities were nonspecific. Cardiomegaly was present in most cases. The main echocardiographic findings were those of additional echoes between the two cusps of the mitral valve during diastole, or an abnormally posterior or anterior position of the posterior cusp during diastole, or the presence of mitral prolapse. Other nonspecific signs were frequently present. Left cineangioventriculography showed a significant degree of mitral leakage during diastole in all patients. All 9 patients had an operation or came to post mortem; rupture of the chordae was confirmed in 6 of them. As far as the other 3 cases were concerned, two of them had lengthening of the mitral cordae, and the last had mitral prolapse associated with endocardial vegetation. A further group of 60 patients undergoing surgery for mitral incompetence without rupture of the chordae allowed us to establish that there were no false negative results on the echocardiogram.
 ...
PMID:[Rupture of the mitral valve chordae. Electrocardiographic, clinical and angiographic findings]. 10 74

Two hundred angio-cardiograms of patients with confirmed myodardial infarcts or angina pectoris were analysed. Patients with rheumatic heart disease were not included. In each patient the left ventricule and coronary vessels had been demonstrated and pressure measurements taken. In 8.5% there was prolapse of a mitral valve leaflet. In two thirds of these produced mitral insufficiency.
 ...
PMID:[Prolapse of the mitral valve in coronary heart disease (author's transl)]. 15 32

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.
 ...
PMID:Calcification of the mitral annulus: etiology, clinical associations, complications and therapy. 15 99

Echocardiographic studies were performed in 190 consecutive patients with mitral valvular prolapse. All patients had either midsystolic posterior motion of the mitral valve or holosystolic hammock-like movement of the valve in systole. Thirteen patients (7 percent) were noted to have ruptured chordae tendineae. In four patients, a combination of abnormalities was observed. Five patients had clinical and bacteriologic evidence of infective endocarditis, two of whom had severe intractable pulmonary edema consequent to acute mitral regurgitation which required mitral valvular replacement. At surgery, one of these patients had ruptured chordae tendineae to both leaflets, and the other had chordal rupture of the posterior leaflet. The other patients probably had spontaneous rupture of the chordae tendineae. A spectrum of clinical findings was noted. Six patients had marked mitral regurgitation, while two had isolated systolic clicks. Thus, chordal rupture does not always result in severe hemodynamic deterioration. Serial echocardiographic studies will be of value in studying the natural history and progression of disease in patients with chordal rupture.
 ...
PMID:Incidence of ruptured chordae tendineae in the mitral valvular prolapse syndrome: an echocardiographic study. 42 75

Myocardial function was evaluated prospectively by noninvasive methods in 20 boys with clinical, biochemical, muscle biopsy, and electromyographic evidence of Duchenne's progressive muscular dystrophy. Auscultatory evidence of a nonejection systolic click suggested mitral valve prolapse (MVP) syndrome in seven patients. Phonocardiography disclosed that the click was mid-systolic in four patients and early in three. Echocardiographic features consistent with this diagnosis were identified in all seven patients and in an additional four. One of these had an apical pansystolic murmur, suggestive of mitral regurgitation, whereas in the other three, prolapse of the mitral valve was "silent". Echocardiographic findings included an abrupt midsystolic, posterior motion (greater than 3 mm beyond the CD line) in five patients, multiple sequence echoes in six, and posterior coaptation of the mitral valve near the left atrial wall in six. The features most characteristic of MVP syndrome was a smooth, pansystolic, anteriorly concave (hammock-like) posterior motion deviating more than 3 mm beyond the CD line. Among the remaining nine patients who did not have echocardiographic evidence of prolapsing mitral valve, none had an early, middle or late nonejection systolic click or a heart murmur, although four patients in this group had moderate to severe scoliosis. These observations document of occurrence of MVP syndrome in children with Duchenne's muscular dystrophy and indicate that its prevalence is high. We speculate that prolapse of the mitral valve in these patients is an expression of the underlying cardiomyopathy characteristic of Duchenne's muscular dystrophy rather than an isolated, dystrophic involvement of the mitral valve leaflets.
 ...
PMID:Mitral valve prolapse syndrome in children with Duchenne's progressive muscular dystrophy. 44 Jul 88

Despite what was considered adequate pharmacological treatment, the condition of six patients with severe mitral valve prolapse but with trivial or no mitral regurgitation deteriorated. These patients had marked weakness, chest pain, dyspnea, and arrhythmias. Because these patients found their condition to be intolerable, the prolapsed mitral valve was repaired. Electrocardiography, treadmill stress testing, and left ventirculography performed following operation showed complete repair of the valve and significant improvement over the preoperative findings in all six patients. Repair of the floppy mitral valve did not eradicate all abnormalities; however, it did significantly improve the chest pain, weakness, dyspnea, and arrhythmias in all six patients. Five patients no longer require any medication. The prolapsed mitral valve contributed significantly to the symptoms and arrhythmias, but it could not have been the sole cause for these patients' signs and symptoms. With complete correction of the prolapse in all six patients, few of the signs and symptoms of the disease persisted. Repair of severe mitral valve prolapse without mitral regurgitation is recommended only for those patients who continue to be severely symptomatic from chest pain, dyspnea, or ventricular arrhythmias after an extensive trial of adequate medical therapy.
 ...
PMID:Surgical correction of severe mitral prolapse without mitral insufficiency but with pronounced cardiac arrhythmias. 45 34

Echocardiographic assessment of left ventricle functions was performed in 52 cases with idiopathic prolapse of mitral valve, confirmed on the base of the simultaneous presence of the well known auscultatory, phonocardiographic and echocardiographic criteria. Mitral prolapse was established not to be a homogenous group as regards left ventricle function. The majority of the cases (80.7%) had normal EchoC-indices for the pump and total and local contraction function of left ventricle. The cases without (25%) or with light stage (55.7%) mitral regurgitation are included here. In the presence of hemodynamic significant mitral insufficiency -- 13.5% of the cases. EchoC-manifestations for volume left-ventricle loading were found -- enlarged telediastolic dimension and volume of the left ventricle cavity, light hypertrophy and hypercontractility of the interventricular septum and/or the unattached posterior wall of left ventricle, enlarged left ventricle, increased velocity of EF-segment of the anterior mitral cusp. As a rule, a moderate mitral regurgitation is concerned in those cases. In a small number of cases with mitral prolapse (5.8%) EchoC-manifestations for a light to moderate pump and general and/or local contraction function of left ventricle was established without clinical data for a stasis in left ventricle cardiac insufficiency. Grounds exist to admit that in the last cases, a rather not severe local or more diffuse lesion of the left ventricle myocardium is concerned, its relationship with the mitral valve prolapse remaining obscure.
 ...
PMID:[Echocardiographic evaluation of left ventricular function in mitral valve prolapse]. 49 32

Quantitative angiographic findings were reviewed in 40 patients with significant mitral regurgitation classified into three etiologic groups: group I, primary mitral regurgitation (prolapse, ruptured chordae); group II, mixed stenosis and regurgitation of rheumatic origin; and group III, cardiomyopathic mitral regurgitation. For patients in both groups I and II, left ventricular end-diastolic volume was directly related to regurgitant fraction, and ejection fraction was generally well maintained. In contrast, patients in group III had a depressed ejection fraction (less than 0.40) and end-diastolic volume that was disproportionately increased in relation to the degree of regurgitation. Left ventricular end-diastolic pressure was a poor indicator of severity of regurgitation in all patient groups. There was a significant negative correlation between forward cardiac index and regurgitant fraction. There was significant relation, although with considerable variation, between the normalized V wave and regurgitant fraction. The graphs of chamber size, ejection fraction and hemodynamic measures plotted against the severity of regurgitation in different patient groups provide a perspective for interpreting the findings in individual patients.
 ...
PMID:Ventriculographic and hemodynamic features of mitral regurgitation of cardiomyopathic, rheumatic and nonrheumatic etiology. 55 77

A heroin addict with asymmetric septal hypertrophy and persistent fungemia with Candida parapsilosis was treated with amphotericin B and flucytosine (5-fluorocytosine). The diagnosis of endocarditis was based on the subsequent development of a murmur of mitral regurgitation and echocardiographic evidence of prolapse of the posterior leaflet of the mitral valve. Cure was effected with antifungal therapy alone. Thus, when the diagnosis of fungal endocarditis is made early in its course, open-heart surgery may not be needed. To investigate the relative frequency of isolation of C parapsilosis from particular sites, a mycologic survey was conducted in our hospital. Among the isolates of yeasts, C parapsilosis represented 8.0, 17.1, and 26.7 percent of those from all cultured sites, from contaminated intravenous catheters, and from cultures of blood, respectively. Since this trend to cluster in cases of fungemia was not seen with other yeasts, C parapsilosis appears to be more invasive than other species of Candida.
 ...
PMID:Successful medical therapy for endocarditis due to Candida parapsilosis. A clinical and epidemiologic study. 63 Sep 78

The characteristic ultrasono-cardiographic (UCG) findings of prolapsed mitral valve were studied in 9 cases by means of ultrasonocardiotomography (UCT). The changes in degree and shape of the prolapsed valve were examined and the leaflet involved was identified. Of the 9 cases, 5 had prolapse of anterior, 3 had that of posterior leaflet and 1 had both. In all cases with midsystolic click and late systolic murmur or pansystolic murmur with late systolic accentuation, the prolapse of anterior leaflet was observed on UCT, and though UCG disclosed midsystolic buckling it was difficult to determine the exact timing of the prolapse by UCG alone. In the cases with rheumatic mitral regurgitation, the prolapse of posterior leaflet and the ballooning of anterior leaflet could easily be found on UCT, but the detection of the above-mentioned 2 findings was difficult by UCG alone. Three of the 9 cases were found to have prolapse of posterior leaflet by left ventriculography, whereas these 3 had prolapse of anterior leaflet on UCT. Hence, the diagnosis of prolapsed mitral valve based on the cineangiography may require re-evaluation.
 ...
PMID:Ultrasono-cardiographic diagnosis of the prolapsed mitral valve. 65 Sep 3


1 2 3 4 5 6 7 8 9 10 Next >>