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 case of isolated ectasia of the entire right coronary artery and mitral valve prolapse is reported. The patient presented with acute inferior myocardial infarction and progressive angina pectoris. The diagnosis of ectasia of the right coronary artery and mitral prolapse was established angiographically. During a two-year follow-up period, the patient has continued to have angina and has suffered a second inferior myocardial infarction. Subsequent angiographic reevaluation has failed to show occlusive coronary lesions. It is suggested that distal thromboembolism due to changes in the character of blood flow in the dilated vessel has been responsible for the two episodes of myocardial infarction and persistent angina pectoris.
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PMID:Mitral valve prolapse (MVP) and coronary artery ectasia. 66 23

Echocardiography was performed in 25 consecutive patients with angina pectoris and angiographically demonstrable coronary artery disease. Left ventricular echograms detected late or pansystolic mitral valve bowing suggesting of mitral valve proplapse in 6/25 (24%). Left ventricular angiography showed prolapse of the posterior mitral leaflet in 15/25 (60%), including 5 detected by echocardiography. Significant triple vessel coronary disease was present in 11 of 15 patients with prolapsed mitralvalve. In each of the latter a greater than 90 per cent obstructive lesion was noted in at least one coronary artery: right coronary artery, 9 subjects (82%); left circumflex coronary artery, 5 patients (33%); and left anterior descending coronary artery, 4 patients (27%). Of 15 subjects with angiographic evidence of mitral valve prolapse, 13 had left ventricular asynergy-inferior or inferoposterior in 8 subjects (62%) and anterior or anteroapical in 5 subjects (38%). Eleven subjects had vectorcardiographic evidence of transmural myocardial infarction-inferior or inferoposterior in 9 (82%) and anteroseptal in 2 (18%). A single subject with mitral valve prolapse had mild mitral regurgitation. It is concluded that: (1) coexisting prolapse of the posterior mitral valve leaflet and coronary artery disease is usually associated with triple vessel obstructive lesions, (2) severe right coronary disease, inferior left ventricular wall asynergy, and inferior myocardial infarction are important angiographic and vectorcardiographic correlates, and (3) echocardiography will detect such mitral valve prolapse in only one-third of affected cases.
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PMID:Mitral valve prolapse in patients with coronary artery disease. Echocardiographic-angiographic correlation. 83 37

A prospective, randomized study comparing abdominal rectopexy and sigmoid resection (Group I; n = 15) with polyglycolic acid mesh rectopexy without sigmoidectomy (Group II; n = 15) for complete rectal prolapse was carried out. One patient in Group I died of myocardial infarction, one patient in Group II had a small bowel obstruction and two patients in Group I an asymptomatic stricture of the anastomosis. Otherwise a safe and efficient control of the prolapse was achieved in both groups. Eleven (73%) patients in Group I and 12 (80%) patients in Group II were more or less incontinent before surgery. After correction of prolapse incontinence improved in eight and ten patients in Groups I and II, but became slightly worse in one patient in Group II. A similar rise in anal pressures was measured in both groups after surgery. Constipation disappeared in three and seven patients in Groups I and II six months after surgery, but five additional patients in Group II became severely constipated and colectomy had to be performed in one of them. Surgery caused no significant change in colonic transit times even though increased transit times were measured in each group six months postoperatively. Sigmoid resection in conjunction with rectopexy does not seem to increase operative morbidity but tends to diminish postoperative constipation possibly by causing less outlet obstruction.
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PMID:Abdominal rectopexy with sigmoidectomy vs. rectopexy alone for rectal prolapse: a prospective, randomized study. 133 91

32 women with genuine stress urinary incontinence were operated on via the transvaginal approach during 1989-1990. They ranged in age from 27-72 years, with a mean of 55.7. In 26, in addition to the urine leakage, vaginal wall prolapse of various degrees was diagnosed. 6 underwent Raz modified Pereyra bladder neck suspension, 26 had Raz 4-corner bladder and bladder neck suspension, and in 17 rectocele and perineal repair were also performed. 2 with uterine prolapse also underwent vaginal hysterectomy. At follow-up 2-12 months later 29 of the 32 were completely cured of stress incontinence (90.6%). In 7 urge incontinence persisted in various degrees, and 3 had developed urge incontinence de novo. All but 1 of them responded favorably to anticholinergic medication. There were postoperative complications in 5 (15.6%), including wound infection that required removal of Prolene sutures in 2, urethrovaginal fistula requiring reoperation in 1, perioperative myocardial infarction in 1, and in 1 voiding dysfunction initially treated with self-intermittent catheterization, but later cured by removal of a pair of Prolene sutures.
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PMID:[Surgical treatment of urinary stress incontinence in women]. 175 77

Clinical appearance and misdiagnosis in 27 patients having associated preexcitation syndrome and mitral prolapse have been analyzed. Misdiagnosis of myocardial infarction, rheumatic and congenital heart disease, infectious-allergic myocarditis were most typical errors in this condition identification: in 9, 3 and 2 patients, respectively.
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PMID:[Causes of diagnostic errors in ventricular pre-excitation syndrome associated with mitral valve prolapse]. 187 57

Fifty consecutive patients with a newly acquired systolic murmur and severe cardiac decompensation following a recent myocardial infarction (27 with an anterior and 23 with an inferior infarct) were studied by a combination of two-dimensional echocardiography, spectral Doppler and Doppler color flow mapping. The initial ultrasound study defined a ventricular septal rupture in 43 patients and severe isolated mitral regurgitation in 7 patients (5 with papillary muscle rupture and 2 with severe papillary muscle dysfunction). All 50 patients had subsequent confirmation of the diagnosis by either cardiac catheterization or surgical inspection, or both. Two-dimensional echocardiography alone directly visualized a septal defect in only 17 (40%) of the 43 patients with ventricular septal rupture. In all 43 patients the mitral valve appeared normal on imaging. In six of the seven patients with isolated mitral regurgitation, two-dimensional echocardiography correctly demonstrated the structural abnormality of the mitral valve (five with flail anterior leaflet and one with posterior leaflet prolapse). The addition of Doppler color flow mapping greatly improved the diagnostic information in both patient groups. In all 43 patients with ventricular septal rupture, Doppler color flow mapping demonstrated both an area of turbulent transseptal flow and a diagnostic systolic flow disturbance within the right ventricle. In the seven patients with isolated papillary muscle rupture or dysfunction, Doppler color flow mapping not only demonstrated the presence of mitral regurgitation in all cases, but also identified the specific mitral leaflet abnormality by defining the direction of the regurgitant jet.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Doppler color flow mapping in the diagnosis of ventricular septal rupture and acute mitral regurgitation after myocardial infarction. 232 47

From 1984 to 1988, 129 mitral valve reconstructions were done for primary pure mitral regurgitation. Sixty-two (48%) were done for myxomatous degeneration and prolapse of the mitral valve. Anterior leaflet resection was performed in seven patients, posterior leaflet resection in 46, anteroposterior resection in four; five patients received only a ring annuloplasty. Eight patients had coronary bypass grafts. Twenty-four patients received a Carpentier-Edwards annuloplasty ring, 24 a Duran ring, and 14 patients had no ring. Follow-up was 1 to 50 months (mean, 13 months). No patient was lost to follow-up. There was one operative death from gastrointestinal bleeding and two late deaths (one from suicide and one from a myocardial infarction), and the probability of survival at 48 months was 84% +/- 15%. There were no thromboembolic episodes or episodes of endocarditis. However, there were five reoperations (9%) with freedom from reoperation at 48 months of 85% +/- 5%. There was one major anticoagulant hemorrhage. Freedom from all morbidity at 48 months was 81% +/- 8%. Postoperative echocardiographic data in the three different groups of patients undergoing repair on the basis of annuloplasty treatment showed that the peak gradient was less and the valve area was slightly greater with no annuloplasty ring.
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PMID:Mitral valve repair for myxomatous degeneration and prolapse of the mitral valve. 281 29

Thirty-one autopsy cases of patients (20 men, 11 women) who died within 5 days of the onset of primary posterior wall myocardial infarction due to occlusion of the right coronary artery (RCA) were divided into two groups: Group A (19 cases) with associated right ventricular infarction and Group B 812 cases) without right ventricular extension of the infarct. The causes of death were practically identical in the two groups except for cardiac rupture which was always septal and more common in Group A. In Group A, the complete occlusion of the RCA was always proximal to (18 cases) or at the site of origin (1 case) of the right marginal artery. Twelve cases (63 p. 100) of tricuspid regurgitation were detected in Group A but there were no such cases in Group B. Tricuspid regurgitation was associated with a significantly poorer short term prognosis. It was not related to a greater degree of dilatation of the tricuspid ring but to more severe septal and right ventricular infarction causing prolapse of the septal and posterior septal leaflets into the right atrium. A second group of autopsy cases comprised 40 patients dying in the long term (1 to 14 years later) after primary posterior wall infarction. In 15 cases (Group A) the post-mortem study showed chronic right ventricular infarction, an extension of a chronic left ventricular infarct. These findings were absent in the other 25 cases (Group B). The mean survival times (Group A : 6.1 years, Group B : 5.9 years) were comparable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tricuspid insufficiency in posterior infarction caused by occlusion of the right coronary artery. Anatomical study]. 293 Oct 59

The clinical and echocardiographic features of right atrial thrombi were examined in 9 patients, 5 men and 4 women aged 16 to 86 years. The 2D echocardiographic diagnosis was confirmed at autopsy (4 cases) or by the association of severe recurrent pulmonary embolism (5 cases). Three patients had associated ischaemic heart disease and on patient had dilated cardiomyopathy. The clinical presentation was: acute cor pulmonale (5 cases including 2 patients which biventricular myocardial infarction), chronic post-embolic cor pulmonale (1 case), tricuspid valve obstruction (1 case), general ill health with pyrexia (1 case) and heparin-induced thrombocytopenia (1 case). Predisposing factors included: absence of anticoagulent therapy (7 cases), previous supraventricular arrhythmias (2 cases) and right ventricular failure (6 cases, including 2 of right ventricular infarction). In 2 patients the thrombi were relatively immobile and had a wide base of implantation on the interatrial septum; in 1 patient, multiple thrombi were observed lining the right heart cavities from the inferior vena cava to the pulmonary infundibulum. In the other 6 patients, the thrombi were very mobile with a visible pedicule of implantation (2 cases) or totally free (4 cases). The variable polylobulated appearances, completely irregular whirling motion and intermittent prolapse into the tricuspid valve were characteristic features of the latter 4 cases. They disappeared spontaneously (2 cases) or after fibrinolytic therapy (2 cases) in under 36 hours. Three patients were operated with one postoperative death. The global hospital mortality was 22%. The present occasional detection of right atrial thrombosis will certainly become more common if patients with pulmonary embolism, right ventricular infarction or deep venous thrombosis are systematically examined by 2D echocardiography in the acute phase of their illness.
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PMID:[Clinical, echocardiographic and evolutive aspects of right atrial thrombosis]. 308 12

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


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