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)

Isovolumic relaxation time (IVRT) was determined in 17 controls and 41 patients. Nine patients had ischemic heart disease (IHD), 7 mitral prolapse (MVPS), 13 hypertension (HPB), 7 pregnancy (P), and 5 cardiomyopathy (CM). Echocardiographic measurements of IVRT were made from the aortic second sound to the rapid opening of the mitral valve (A2D1). Determinations by apexcardiography were made from the aortic second sound to the 0 point (A2O). The IVRT was distinctly shorter when assessed by A2D1 than by conventional apexdardiography in conventional apexcardiography in controls (69.2 +/- 16.4 msec vs 118.7 +/- 16.5 msec) and in patients with cardiac disease. The IVRT in 9 older normal controls (mean age 47.7 years) was longer than in 8 younger ones (age 26.3 +/- 4.9 years). Patients with myocardial disease (IHD, HBP, and CM) had prolonged IVRTs when compared to normal subjects. Pregnant subjects had shortened intervals. IVRT may be a sensitive indicator of disturbances in myocardial contractility and may be shortened and enhanced contractility.
 ...
PMID:Isovolumic relaxation time in normal subjects and patients with cardiac disease: comparison of determinations made with echocardiographic techniques and apex cardiography. 62 24

Mitral leaflet prolapse syndrome has been associated with anginal chest pain, atypical chest pain, electrocardiographic abnormalities and positive stress electrocardiograms. These features overlap those of ischemic heart disease. Furthermore, coronary artery disease is frequently associated with mitral leaflet prolapse. This study evaluated the usefulness of stress myocardial scintigraphy in distinguishing these two disorders. Thirty-two patients with an angiographic diagnosis of mitral leaflet prolapse were studied. Of the 22 patients (8 men and 14 women, mean age 48 years) with a normal coronary arteriogram, 5 had "typical" angina pectoris, 6 had resting electrocardiographic abnormalities and 6 had a positive stress electrocardiogram; all 22 patients had a normal stress myocardial scintigram. Of the 10 patients (7 men and 3 women, mean age 55 years) with at least 70 percent stenosis of one coronary artery, 6 had "typical" angina pectoris, 1 had resting electrocardiographic abnormalities and 7 had a positive stress electrocardiogram. Nine of these 10 patients had one or more demonstrable perfusion defects on stress myocardial scintigrams. It is concluded that mitral leaflet prolapse syndrome is not associated with regional myocardial ischemia as demonstrated with stress scintigraphy, and that stress scintigraphy, a noninvasive technique, is useful in distinguishing the mitral prolapse syndrome from mitral prolapse associated with coronary artery disease.
 ...
PMID:Stress myocardial imaging in mitral leaflet prolapse syndrome. 70 87

A man evaluated for disabling chest pain was found to have isolated anatomically corrected transposition of the great vessels. Angiography demonstrated right and left atrioventricular (A-V) valve prolapse and normal coronary arteries. Atrial pacing produced chest pain, ischemic electrocardiographic changes, abnormal myocardial lactate metabolism and marked elevation of the left ventricular end-diastolic pressure; all of these changes returned to normal on termination of pacing. The association of corrected transposition and bilateral A-V valve prolapse and the possible causes of myocardial ischemia in this patient are discussed.
 ...
PMID:Chest pain and bilateral atrioventricular valve prolapse with normal coronary arteries in isolated corrected transposition of the great vessels. Clinical, angiographic and metabolic features. 90 44

Echocardiographic observations in 200 subjects with mitral valve prolapse (MVP) are presented. The diagnostic criteria used were: (1) abrupt late systolic posterior motion of one or both leaflets of the mitral valve, and (2) holoor pansystolic posterior motion of 3 mm of one or both leaflets of the mitral valve. Most of the subjects were young--72% were aged less than 30 years. Prolapse of posterior leaflets was noted in 98% of subjects--69.5% late systolic, 28.5% pansystolic, and 2% had prolapse of the anterior mitral leaflet only. Mitral valve prolapse was considered to be primary--being the only abnormality in 78.5% of the subjects. In the remaining 21.5% MVP was associated with other cardiac lesions, the commonest being, atrial septal defect (2.5%), dilated aortic root (2%), bicuspid aortic valve (2%), cardiomyopathy (5%), rheumatic heart disease (4%) and ischaemic heart disease (1.5%). Mitral valve prolapse was considered to be important enough to result in haemodynamically significant mitral regurgitation in only 8% of subjects. Mitral valve prolapse was the commonest single echocardiographic abnormality (16%) observed in patients referred to this university hospital, which is the referral centre for approximately half of Libya. Although this does not indicate the prevalence of MVP in the general population, this study indicates MVP to be the commonest valvular abnormality seen in hospital practice in Libya.
 ...
PMID:Echocardiographic features of mitral valve prolapse in Libyan patients. 254 92

The syndrome of primary mitral leaflet billow, with or without prolapse, is associated with myxomatous degeneration of the mitral valve apparatus, mainly the posterior leaflet, and the syndrome may be familial. It manifests clinically with an isolated nonejection systolic click (billow), a murmur of mitral regurgitation that is usually late systolic (prolapse), or a combination of murmur and click. Echocardiography identifies and assesses the extent of the billowing of mitral leaflet bodies but there are no specific echocardiographic criteria that can differentiate normal from pathological billowing. Similarly, a prolapsed leaflet is not detected echocardiographically when there is localized and mild failure of leaflet edge apposition but a more severely prolapsed, or flail, leaflet can be demonstrated and confirmed by that technique. Symptoms of the syndrome include anxiety, chest pain and palpitations. The resting electrocardiogram may show ST segment and T wave abnormalities. The majority of patients have a benign course and require reassurance only. Complications include systemic emboli, infective endocarditis, progression to severe mitral regurgitation, arrhythmias and, rarely, sudden death. Patients with prolapse of a leaflet edge are more likely to develop complications than those with only billowing of the leaflet bodies. Surgery, preferably valvuloplasty, is required for severe regurgitation and may also be indicated for potentially lethal tachyarrhythmias unresponsive to medical therapy. Mitral leaflet billow and prolapse may be secondary to, or associated with, many conditions. The prognosis is then principally that of the underlying disease of which ischemic heart disease and hypertrophic cardiomyopathy are the most important.
 ...
PMID:Mitral valve billowing and prolapse: perspective at 25 years. 304 85

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.
 ...
PMID:[Clinical, echocardiographic and evolutive aspects of right atrial thrombosis]. 308 12

The aim of this study was to assess the diagnostic value of pulsed and continuous wave Doppler in mitral regurgitation. One hundred and twenty-one patients (64 women and 57 men aged 13 to 76 years, average 54 years) investigated for mitral regurgitation or ischaemic heart disease underwent left ventricular angiography and continuous wave and pulsed Doppler echocardiography. In addition to clinical examination, they also underwent M mode, 2D echocardiography and phonocardiography. They were divided into two groups according to the presence or absence of mitral regurgitation on angiography, chosen as the reference method. Group I comprised 51 patients with angiographic regurgitation, and Group II 70 patients without mitral regurgitation. The sensitivity of the Doppler examination was 98%. Of the 51 patients in Group I there was only one false negative in a patient with doubtful angiographic regurgitation in the context of an endocardial cushion defect. In comparison, the sensitivity of clinical examination and phonocardiography were 74.5% and 80% respectively; 13 cases of mitral regurgitation on angiography and Doppler echocardiography had no auscultatory signs. The specificity of the Doppler examination was 92.8%; 5 of the 70 patients in Group II had unquestionable systolic turbulence in the left atrium and 2D echocardiography showed the possible mechanism of these valvular leaks in 3 cases: 1 bivalvular prolapse, 1 rheumatic valvular thickening and 1 papillary muscle dysfunction. We interpret these 5 cases as being true mitral regurgitation but intermittent or too slight to be visible on angiography. The positive predictive value of systolic turbulence in the left was 90.9% and the negative predictive value was 98.4%.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Pulsed and continuous Doppler in qualitative and quantitative diagnosis of mitral insufficiency]. 309 Sep 65

Mitral valve prolapse frequently resembles coronary heart disease. Retrospective clinical, ECG and angiographic analysis of 100 consecutive patients with mitral prolapse and normal coronary arteries, but complaining of anginal pain, shows how difficult it is to establish the correct diagnosis. When resting, 44% of patients have nonspecific ECG disorders of repolarization phase. During periods of chest pain 3 patients experienced transient ST segment changes very similar to acute myocardial ischemia. The exercise test was positive in 39% of cases, and in 2 patients during exercise a sudden drop in blood pressure suggested coronary perfusion failure. In all patients the coronary arteries were normal, but left ventriculography showed mitral valve prolapse predominantly on the posterior leaflet. At rest, 35% of patients had diastolic compliance failure, 32% had left ventricular hyperkinesia and only in 3% was slight hypokinesia present. Finally, early systolic relaxation of the anteroapical wall was observed in 75% of patients.
 ...
PMID:[Mitral prolapse syndrome: clinical, electrocardiographic and angiocardiographic correlations. Study of 100 patients with healthy coronary vessels]. 396 47

Current knowledge concerning idiopathic prolapse of the mitral valve is illustrated. The histopathological cause is myxoid degeneration of the mitral cusps, which sometimes extends to the tendinous cords, the valve implant ring, and the apex of the papillary muscles. Primary damage to these structures, whose intactness is essential for correct closure of the ostium, causes protrusion of the ventricular cusps into the left atrium during ventricular systole (i.e. prolapse). The reason for this degeneration is not known. The high familial incidence of prolapse lends credit to the most widely held suggestion, namely a hereditary defect. The clinical progress is benign in the great majority of cases ("crystallized" form) and is often asymptomatic. Complications are possible, however, and must always be borne in mind. They include progressive and acute mitral insufficiency, infective endocarditis, arrhythmias, motor or sensitive neurological complications, and sudden death. Particular attention must be paid to the path to be followed to arrive at the correct diagnosis. Careful evaluation of some of the clinical signs arousing suspicion in the previous history and/or objective examination enable a diagnosis to be formed with relatively simple, non-invasive instrumental techniques, such as echocardiography and polycardiography, provided other forms of prolapse secondary to ischaemic heart disease, mitral endocarditis, etc. are excluded. "Therapy is obviously necessary in the presence of complications; however, even in "crystallized" form, in the presence of subjective symptoms, tranquillizers and possibly beta-blockers may be necessary".
 ...
PMID:[Idiopathic mitral valve prolapse]. 613 73

One hundred and eighty-two patients (100 females, 82 males) with mitral valve prolapse (MVP) confirmed by echocardiography are described. Their ages range from 12 to 87 years (mean 48 years). The symptoms of breathlessness, pain in the chest and palpitations were analysed. They were associated with left ventricular failure, co-existing ischaemic heart disease and arrhythmias in some, but in a proportion the symptoms were thought to be due to psychoneurosis. Seventy-two patients (40 per cent) were referred because of complications of MVP. In 67 patients (37 per cent) the condition was discovered by chance and in 43 patients (24 per cent) neurotic symptoms had led to referral to hospital. A systolic click was heard in 117 patients (54 per cent); 41 patients (23 per cent) had a late systolic murmur and 30 patients (16 per cent) had a pansystolic murmur. The incidence of murmurs rose with increasing age, and pansystolic murmurs were more frequent in males. Thirty-two patients (18 per cent) had neither a click nor a murmur. Twenty-four patients (13 per cent) had associated supraventricular tachycardia and 22 (12 per cent) atrial fibrillation. Twelve patients (7 per cent) had severe mitral incompetence and eight (4 per cent) developed bacterial endocarditis. Only three patients had symptoms suggesting cerebral ischaemia. Twelve patients (7 per cent) had associated aortic incompetence. Twenty-two patients had had an inguinal hernia, the incidence in males over 50 being 26 per cent. Twenty-six patients (14 per cent) had non-specific T wave changes in the electrocardiogram. Echocardiography showed that 112 patients (62 per cent) had mid-systolic buckling of the posterior leaflet and 70 patients (38 per cent) had holosystolic prolapse. In view of the high incidence of complications it is felt that the long-term prognosis not as good as has been generally believed.
 ...
PMID:Mitral valve prolapse: an assessment of clinical features, associated conditions and prognosis. 661 38


1 2 3 Next >>