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)

Twenty panic disorder patients with mitral valve prolapse showed amelioration of prolapse on repeat echocardiogram after treatment for panic disorder. This effect was significant when compared to repeat echocardiograms in eight psychiatrically normal control subjects with mitral valve prolapse.
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PMID:Amelioration of mitral valve prolapse after treatment for panic disorder. 141 30

Panic disorder with or without agoraphobia is dominated by the occurrence of panic attacks. However, panic attacks are also reported to occur as part of the clinical picture in several medical conditions, notably thyroid disease, hypoglycemia, and pheochromocytoma. The authors examine these conditions, review the relevant literature, and offer an evaluation strategy. Routine screening is not recommended. Panic disorder is also associated with mitral-valve prolapse and temporal lobe seizures. The authors explore the possible consequences of this association and outline an evaluation strategy. Again, routine screening is not recommended.
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PMID:Medical evaluation of panic attacks. 330 23

In spite of two decades of research, the precise relationship of anatomic mitral valve prolapse (floppy valve) to the neuroendocrine disorder (MVP syndrome) remains unclear. In all likelihood they are two separate genetic disorders which travel together in some fashion. Mitral valve prolapse is a common disorder but progressive mitral regurgitation usually occurs late in life and in only a few patients. Other complications such as bacterial endocarditis, stroke, and sudden death are far less common but can occur at younger ages. The neuroendocrine syndrome in civilian life is mainly seen in young females (interestingly the peak incidence years correspond to peak female sex hormone output) but can be seen in males when subjected to unusual stress such as military service. More recent echocardiographic studies have questioned whether all prolapsing valves are truly abnormal. It has been shown that echographic prolapse can be produced in normal subjects by reducing venous return and impaired venous return may be present in some patients with the MVP syndrome. However, clicks and murmurs are apparently not heard when normal valves prolapse. It is our opinion that the presence of a click or typical murmur requires some anatomic abnormality of the mitral valve. One wonders if minimal valve abnormality (noted and dismissed by Davies) is the valve abnormality present in many young females with MVP syndrome, and that it may remain a mild abnormality throughout life. Recent psychiatric studies suggest that MVP is present in 30% of patients with Panic Disorder. It is not clear that this psychiatric syndrome is the same thing as the MVP syndrome. In Devereux's study, anxiety proneness was no different in the MVP cohort than in relatives without MVP. It is possible that diagnostic mixing of two similar but separate disorders has occurred, as has been the case since World War I. Perhaps the most important question is whether young patients with MVP syndrome and no echocardiographic criteria for "floppiness" will develop progressive mitral regurgitation or other complications in later life. In other words, how often is MVP syndrome in a young individual without echocardiographic evidence of a floppy valve a precourser to eventual progressive mitral regurgitation? Are there two different populations? Because of the long course of the disorder, several more years of observation (and, it is hoped, prospective longitudinal study) will be required to answer this question.
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PMID:The mitral valve prolapse epidemic: fact or fiction. 330 18

Mitral valve prolapse (MVP) is due to a heterogeneous group of conditions that may affect the mitral valve or the mitral valve apparatus. Although MVP may progress later in life to frank mitral insufficiency requiring mitral valve repair or may predispose to bacterial endocarditis, in most cases it is a benign, idiopathic condition without serious consequences. However, many investigators have documented that MVP is often associated with a constellation of signs and symptoms, which appear to constitute a distinct syndrome. These associated findings include autonomic dysfunction, frequent complaints of chest pain, palpitations, orthostasis, fatigue, dyspnea on exertion and anxiety. Although the risk of significant myocardial dysfunction or bacterial endocarditis appears to be related to patient sex, age and the severity of valvular prolapse and insufficiency, there appears to be little or no relations between the extent of prolapse and the degree of autonomic dysfunction or the severity of symptoms of chest pain, palpitations, dyspnea on exertion and anxiety. The development of uniform diagnostic standards for mental disorders has helped to make it possible to identify several related entities, including generalized anxiety disorder, panic disorder and agoraphobia; patients with these disorders frequently somatize their anxiety and complain of many symptoms which may be seen in patients with MVP. Although several studies have reported an increased frequency of MVP in patients with anxiety disorders, recent studies suggest that the conditions are not linked. Iatrogenic cardiac neurosis is common in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mitral valve prolapse: from syndrome to disease. 332 70

Whether mitral valve prolapse (MVP) is more common in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP) than in the normal population is controversial. A related issue is whether the presence of MVP in such patients has any clinical or biological significance. Echocardiograms were performed on 36 patients with PD/AgP and 22 normal controls. MVP was found to be more common in PD/AgP patients than in normal controls. However, MVP in the patients was mild and not associated with thickened mitral leaflets or small left ventricular size. Moderate or severe prolapse was uncommon in both groups. Patients with MVP had trends to higher heart rate and prolonged QTc interval on EKG, and reported more respiratory difficulty during panic attacks compared to patients without MVP. Lactate infusion did not affect patients with MVP differently than patients without MVP. The authors conclude that MVP is more common in patients with PD or AgP than in normal controls, but is of doubtful clinical significance.
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PMID:The mitral valve prolapse--panic disorder connection. 337 3

Of 131 patients with panic disorder or agoraphobia, 44 (34%) had definite mitral valve prolapse on the basis of clinical findings of an apical mid- or late systolic click and a murmur and/or a two-dimensional echocardiogram showing prolapse of one leaflet in two views or of two leaflets in a single view. Seven other patients (5%) had a probable diagnosis of mitral prolapse on the basis of a typical murmur alone or an intermittent apical mid- or late systolic click and a prolapsing leaflet in a single echocardiographic view. This finding confirms previous reports of the association between panic disorder and mitral valve prolapse.
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PMID:The prevalence of mitral valve prolapse in patients with panic disorders. 395 93

Our purpose was to determine the incidence of mitral valve prolapse in patients with anxiety neurosis or panic disorder, with symptoms including recurrent anxiety attacks, dyspnea, palpitations, chest pain, dizziness, and paresthesias. Twenty-one patients and 20 age- and sex-matched normal controls were studied. Objective cardiac abnormalities were significantly (p < 0.05) more frequent in the patient group as compared to the control group; these comprised echocardiographic prolapse, ST-T abnormalities on resting ECG, premature ventricular contractions on exercise ECG, and the combination of echo prolapse with clicks/murmurs of exercise-induced PVC. We conclude that patients with anxiety neurosis or panic disorder may also have evidence of an organic abnormality--the mitral prolapse syndrome.
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PMID:Mitral valve prolapse in anxiety neurosis (panic disorder). 740

Pedigree analysis is done on 19 kindreds of panic disorder, and the results suggest that this disorder is transmitted as an autosomal dominant trait. Seven of these 19 kindreds were ascertained through a panic disorder proband with mitral valve prolapse. When the analysis is done omitting these seven kindreds, the results also suggest that panic disorder without prolapse is transmitted as an autosomal dominant trait.
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PMID:A genetic study of panic disorder pedigrees. 742 7

It has been reported that panic attacks might cause mitral valve prolapse (MVP) via haemodynamic or indirect effects. Such prolapse can be classified as being physiological (benign course) or pathological (poor course). It is therefore important to consider whether panic attacks, as a risk factor for MVP, are associated with its physiological or pathological type. Our study sample consisted of two groups of patients with panic disorder (PD), one having onset within 1 year (n=24) and the other with a history of more than 10 years (n=21). Demographic data, symptom presentations, auscultatory and echocardiographic findings of both groups were compared, but no significant difference was found except with regard to anticipatory anxiety. It is concluded that panic attack exerts no significant effect on mitral valve prolapse.
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PMID:The effect of panic attack on mitral valve prolapse. 942 35

To study a role of psychogenic and somatogenic factors in the development of organic neuroses, 302 patients were examined: 199 with cardioneurosis and 103 with irritable-bowel syndrome (IBS) with mental and subclinical somatic pathology or without it. Two types of organic neuroses were distinguished: a conversive one--somatized hysteria (psychogenically determined subsyndromal hysterohypochondriac phobic or affective reactions with clear difference of algesic and autonomic disorders from symptoms of the somatic pathology, with polymorphism of the involved organic systems); and autonomic neurosis that is a central link in the structure of psychosomatic correlations, which, on the one hand, was overdone by clinical manifestations of the somatic pathology (mitral prolapse--35%, ventricular extrasystoles--12%, etc. in cardioneurosis, lymphoid hyperplasia of colonic mucosa--100%, dysbiopsis--10%, etc. in IBS); on the other hand, autonomic neurosis is a somatopsychic component of psychopathologic disorders of anxious-phobic, affective and hypochondriac sphere (panic disorder--59%, generalized anxiety--15%, anxious depression--18% in cardioneurosis, melancholic or hypochondriac cyclothymic depressions--76%, hypochondriac development--24% in IBS). Psychosomatic correlations were considered in autonomic neurosis in the context of some continuum, where somatic disorders amplified by functional disorders are on the one pole and true mental pathology including somatoautonomic disorders--on the other pole. Recommendations have been formulated on therapy of organic neuroses with anxiolytics, antidepressants and atypical neuroleptics in combination with somatotropic drugs.
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PMID:[Organic neuroses as psychosomatic problem]. 1119 35


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