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

Three patients with mitral valve prolapse, high grade ventricular arrhythmias and a strong family history of sudden death were studied utilizing continuous Ecg monitoring and intracardiac stimulation and recording techniques. Analysis of 6-hour ambulatory Ecgs revealed frequent premature ventricular beats (PVBs) including repetitive and multiform PVBs in each patient. The electrophysiological studies demonstrated normal parameters of intracardiac conduction and refractoriness providing no evidence for reentrant mechanisms. Acute drug testing with 0.4 mg sublingual nitroglycerin completely suppressed all ventricular arrhythmias. During maintenance therapy antiarrhythmic nitrate efficacy was only partly confirmed monitoring the effects of 4 x20 mg isosorbide dinitrate on 6-hour ambulatory Ecgs. The electrophysiological parameters of intracardiac conduction and refractoriness were not significantly altered by 0.4 mg sublingual nitroglycerin. Experimental data obtained from isolated rabbit atria and canine ventricles revealed no significant action of nitroglycerin in the parameters of cardiac automaticity and conduction including transmembrane electrical activity of normal and hypoxically damaged SA nodal, atrial and ventricular fibers. It is concluded that a) PVBs in patients with mitral prolapse appear related to ectopic automaticity; b)nitrates may suppress ventricular ectopy in these patients; c) antiarrhythmic nitrate efficacy is not related to direct membrane effects.
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PMID:Nitrates and ectopic ventricular activity in mitral valve prolapse: clinical and experimental data. 10 83

Nine patients with the Marfan syndrome and 40 of their first degree relatives were evaluated for the presence of cardiac, skeletal and ophthalmologic abnormalities. Aortic root dilatation and mitral valve prolapse were sought by echocardiography, and the metacarpal index was calculated from hand X-rays. Abnormalities of all the tests performed were present in all nine index cases, except for one normal eye exam. Mitral prolapse was present in thirteen relatives (33%) and aortic root dilatation in seven (18%). At least one cardiac abnormality was present in nineteen (47%) relatives. Aortic root dilatation was more common in male relatives; the incidence of mitral prolapse was approximately equal in the two sexes. Abnormal metacarpal index (greater than 8.0) occurred in fifteen of twenty-six relatives examined (58%). Ophthalmologic abnormalities were found in only four relatives. Two relatives had abnormalities of all three organ systems evaluated, five others had abnormalities of two systems, and fourteen had abnormalities of one system. We conclude that cardiac and skeletal abnormalities are demonstrable in a high percentage of first degree relatives of patients with the Marfan syndrome.
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PMID:Cardiac, skeletal and ophthalmologic abnormalities in relatives of patients with the Marfan syndrome. 13 15

The prevalence of mitral valve prolapse has been established in selected groups of patients but not in the general population. The present study was designed to define the echocardiographic spectrum of mitral valve motion in a population of young individuals without clinical evidence of significant cardiac disease or hypertension. Echocardiograms were performed on 136 normal volunteers. Six subjects (4.4 per cent) had mitral valve prolapse. Eighteen subjects (13.2 per cent) had a lesser degree of posterior systolic motion of the mitral valve leaflets which was suggestive but not diagnostic of prolapse. Minor degrees of posterior systolic mitral valve motion may represent a variant of normal. Caution should be exercised in making the echocardiographic diagnosis of mitral prolapse until this question is settled.
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PMID:Echocardiographic spectrum of posterior systolic motion of the mitral valve in the general population. 40 53

We determined the prevalence of mitral valve prolapse (MVP) in presumably healthy young men by studying 107 male house officers and medical students with cardiac auscultation in the supine, sitting and standing positions. Echocardiograms were performed at rest in the supine position before and after amyl nitrite inhalation and were obtainable in 101 subjects. Eleven of the 101 subjects had abnormal findings on auscultation: four had an isolated click and seven had a click and late systolic murmur. Correlation of the independent auscultatory and echocardiographic data in the 101 subjects showed that all seven of the subjects with a click and a murmur had echocardiographic evidence of prolapse. None of the 90 subjects with normal auscultation or the four with an isolated click had an abnormal echocardiogram. All seven subjects with MVP had thoracic skeletal abnormalities, but only one was symptomatic. These data suggest that the prevalence of MVP in healthy young males is similar to the reported 6-10% prevalence in healthy young females.
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PMID:Prevalence of mitral valve prolapse in presumably healthy young men. 42 1

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.
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PMID:Mitral valve prolapse syndrome in children with Duchenne's progressive muscular dystrophy. 44 Jul 88

Echocardiograms of 400 patients with mitral valve prolapse examined at the Peter Bent Brigham Hospital between 1974 and 1977 were reviewed. Eleven patients (3 per cent) were found to have prolapse (10 patients) or large excursion of the tricuspid valve (one patient) and large excursion of the aotric valve (four patients) or dilatation of the aotric root (seven patients) in addition to mitral valve prolapse. Two of these 11 patients underwent mitral valve replacement, and myxomatous degeneration of the valves was noted on pathologic examination. Almost half of the patients with multiple floppy valves (five of 11) had symptoms of congestive heart failure. In contrast to reported series of isolated mitral valve prolapse, in which female preponderance has been documented, 10 of the 11 patients were male. The syndrome of multiple floppy valves may represent either a unique entity or a more advanced form of the same process which underlies mitral valve prolapse.
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PMID:Multiple floppy valves: an echocardiographic syndrome. 44 57

It has been hypothesized that mitral valve prolapse may account for a substantial number of patients who have symptoms of chronic anxiety neurosis. In a previous investigation, this hypothesis was confirmed in eight of 21 patients who had anxiety neurosis. In the present investigation, we reevaluated the hypothesis that persons with anxiety neurosis have impaired exercise ability by exercising 20 of the anxiety neurotics according to a standard treadmill exercise protocol. Compared with the control group, the anxiety neurotics required less exercise to achieve an equivalent heart rate and therefore their estimated maximum oxygen consumption was less, thus confirming the hypothesis. However, this difference was due entirely to the anxiety neurotics with mitral valve prolapse, and those without prolapse did not differ significantly from the controls. This suggests that impaired exercise tolerance in anxiety neurotics may be attributable to a subgroup of these patients with mitral valve prolapse.
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PMID:Exercise and anxiety neurosis: comparison of patients with and without mitral valve prolapse. 44 18

Thromboembolism (TE) occurs in about 20% of patients with rheumatic mitral valve disease, and platelet survival time in these patients has correlated with TE. In patients with mitral valve prolapse, TE appears to occur very infrequently. Platelet survival (autologous labeling with chromium-51) was performed in 26 patients with mitral prolapse. Five patients had a history of stroke, as well as normal cerebrovascular arteriography and shortened platelet survival (average half-time +/- SEM 2.3 +/- 0.18 days; normal half-time 3.7 +/- 0.03 days; n = 26; p less than 0.01). Platelet survival was shortened in seven of 21 patients without TE (33%) (3.3 +/- 0.06 days; p less than 0.01 vs patients with TE). In 138 patients with rheumatic heart disease, platelet survival was shortened in 40 of 41 (98%) with a history of TE (2.3 +/- 0.08 days) and in 76 of 97 (78%) without TE (2.9 +/- 0.07 days; p less than 0.001 vs patients with TE). In patients with mitral prolapse, sulfinpyrazone increased platelet survival (2.4 +/- 0.16 to 2.7 +/- 0.19 days; n = 7; p less than 0.05). Our results suggest that platelet survival time is shortened in patients with mitral prolapse and rheumatic heart disease who have had TE. Of those without TE there is an increased frequency of shortened platelet survival in patients with rheumatic heart disease (78%) compared with those with mitral prolapse (33%), consistent with the infrequency of TE in mitral prolapse.
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PMID:Platelet survival time and thromboembolism in patients with mitral valve prolapse. 44 32

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

Eighty cases with mitral valve prolapse excluding the secondary prolapse of the mitral valve caused by known underlying diseases were studied by real-time ultrasoundcardiotomography and M-mode technic. It was thought that observation of the left ventricle with long axis sector scan was useful and sensitive technic to diagnose the mitral valve prolapse. By comparative study of M-mode technic and ultrasoundcardiotomography, echo sources and the mechanism of so called prolapse patterns such as pansystolic bowing, mid-systolic buckling and multilayered echoes were explained. Pansystolic bowing and mid-systolic buckling were considered as the reliable signs for diagnosis of anterior leaflet prolapse, but were not contributory to diagnose posterior leaflet prolapse and ultrasoundcardiotomographic technic was needed to detect the posterior leaflet prolapse. According to the mode of prolapsing findings by ultrasoundcardiotomograms classification of severity of mitral valve prolapse was undertaken and its grade was expressed as AmPn in which A and P designated prolapse of the anterior and posterior leaflet respectively and m and n indicated the grade of severity in number from zero to five.
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PMID:Diagnosis and classification of the mitral valve prolapse by the ultrasoundcardiotomography and the evaluation of the M-mode technic. 45 78


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