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

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

A case of rhabdomyosarcoma of the left atrium and left ventricle demonstrated by echocardiography was reported. A 31-year-old man was admitted to our hospital for evaluation of recently developed exertional dyspnea. A holosystolic murmur and a protodiastolic sound were audible at the apex. A chest X-ray showed pulmonary congestion without cardiomegaly. The two-dimensional echocardiogram showed a dense stratified mass of echoes occupying the medial half of the left ventricular cavity, and a part of the abnormal mass of echoes was observed to move toward the left ventricular outflow tract during systole. Another small mass attached to the anterior mitral leaflet was also observed to prolapse partly into the left atrium during systole. The interatrial septum showed a thick and hard band of echo in the short-axis view. Right cardiac catheterization revealed pulmonary hypertension and the levogram of the pulmonary angiography showed left atrial and left ventricular filing defects. The repeated echocardiographic study showed the growth of the abnormal mass. The patient underwent operation, but he died of congestive heart failure thereafter. The necropsy diagnosis was rhabdomyosarcoma of the heart, involving the left atrium and left ventricle.
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PMID:[Rhabdomyosarcoma of the heart involving the left ventricle and left atrium]. 664 8

We studied the prevalence of mitral valve prolapse (MVP) in presumably healthy young students using two-dimensional echocardiography and compared their clinical pictures with those of hospital patients with MVP. In 265 students undergoing routine physical examination (228 males and 37 females, aged from 18 to 25 years), 29 (11%) were diagnosed as having MVP. There was no sex difference (11% for males and 8% for females). Anterior leaflet prolapse was seen in 26 cases, and anterior and posterior leaflets prolapse was in 3 cases. Twenty-four of the 29 MVP students revealed neither midsystolic click, late systolic murmur nor holosystolic murmur on phonocardiograms (PCG). These 24 students had no cardiac symptoms and the incidence of electrocardiographic (ECG) abnormalities, such as arrhythmias and ST-T changes, was similar to that of students without MVP (4/24 vs 50/236). In contrast, of 54 patients (32 males and 22 females, aged from 15 to 25 years) who were diagnosed as having MVP in the hospital, 28 patients (52%) had no PCG abnormalities. The anterior leaflet was predominantly involved in 42 patients and both anterior and posterior leaflets in 12 patients. These 28 patients visited the hospital because of cardiac symptoms; dyspnea on exertion (3 patients), palpitation (2 patients) or atypical chest pain (7 patients), or abnormal physical examination (11 patients). ECG abnormalities were noticed in 15 of 28 patients (54%). The prevalence of cardiac symptoms and ECG abnormalities were similar to those in 26 patients with PCG evidence of MVP. It was concluded that the prevalence of MVP in young healthy students is 11% and the anterior leaflet is predominantly involved. Most cases were asymptomatic and had no PCG or ECG abnormalities. In contrast, age-matched MVP patients, diagnosed in the hospital with the same two-dimensional echocardiographic criteria, demonstrated similar predominancy of the anterior leaflet prolapse, but had more cardiac symptoms and ECG abnormalities, irrespective of the presence or absence of PCG findings.
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PMID:[Two dimensional echocardiographic diagnosis of mitral valve prolapse syndrome in presumably healthy young students]. 711 94

A case of traumatic tricuspid regurgitation with bilateral pericardial lacerations is presented. The patient was a 68-year-old male with a chief complaint of dyspnea on exertion, who had had chest contusion in an automobile accident 17 years before. Two dimensional echocardiography demonstrated a systolic prolapse of the tricuspid anterior leaflet resulting in massive regurgitation. The right atrial v wave was 25 mmHg. Intraoperative findings were as follows: Three healed tears of 4-6 cm long were present in the both sides of the pericardium. The chordae tendineae of the anterior leaflet were ruptured. The tricuspid valve was replaced with a SJM valve prosthesis. To our knowledge, no case of combined tricuspid insufficiency and bilateral pericardial laceration resulting from blunt injury has ever been reported.
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PMID:[A case of traumatic tricuspid regurgitation with bilateral pericardial laceration]. 872 66

A 22-year-old man developed exertional dyspnea 2 years after blunt chest trauma due to a horse kick. Preoperative echocardiography showed severe tricuspid insufficiency (TI) caused by chordal rupture and prolapse of the anterior leaflet. A novel repair technique, the "clover technique," was applied, but was unsuccessful in this case. The valve was then repaired successfully using conventional techniques, that is, insertion of an artificial chordae, plication of the prolapsing leaflet, and DeVega's annuloplasty. We present here a brief review of posttraumatic TI, and discuss effective and less expensive techniques for repair.
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PMID:Posttraumatic tricuspid insufficiency successfully repaired by conventional technique. 1598 38

Heart failure is important in determining the prognosis of cardiomyopathy caused by mitochondrial gene abnormalities. We report herein the case of a patient with pericardial effusion and heart failure in whom mitochondrial cardiomyopathy was definitively diagnosed. A 56-year-old woman consulted her primary physician with exertional dyspnea. Examination revealed edema and pericardial effusion, and diuretics were prescribed. However, after marked left ventricular hypertrophy (LVH) was noted, she was admitted to our hospital for further evaluation. Further examination revealed short stature, ptosis, generalized muscle atrophy, and sensorineural hearing loss. Echocardiography showed LVH, a global decrease in wall motion, and pericardial effusion. Physical and laboratory findings, including glucose intolerance and elevated serum lactate, suggested mitochondrial cardiomyopathy. Genetic testing confirmed cardiomyopathy due to a mitochondrial a3243g mutation. After treatment to improve heart failure, marked washout was shown on (99m)Tc-MIBI (methoxyisobutylisonitrile) myocardial scintigraphy, suggesting a correlation with mitochondrial dysfunction.
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PMID:A case of mitochondrial cardiomyopathy with pericardial effusion evaluated by (99m)Tc-MIBI myocardial scintigraphy. 1977 18

Isolated left ventricular noncompaction cardiomyopathy (IVNC) is a cardiomyopathy thought to be caused by arrest of normal embryogenesis of the endocardium and myocardium. This abnormality is often associated with other congenital cardiac defects. A 21-year-old man presented to the emergency department with worsening exertional dyspnea during the previous 2 months. Two-dimensional and Doppler echocardiography revealed an enlarged left atrium (LA) and a markedly dilated left ventricle (LV) with preserved LV systolic function, severe mitral valve regurgitation, and prolapse due to chordae rupture. The myocardium of the LV and right ventricle (RV) had excessively prominent trabeculations and deep intertrabecular recesses. He is the first patient in Korea who has undergone mitral valve replacement surgery because of severe mitral valve regurgitation and prolapse due to chordae rupture accompanied by IVNC.
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PMID:Isolated left ventricular noncompaction cardiomyopathy accompanied by severe mitral regurgitation. 1999 46

Hypothyroidism can cause a variety of signs and symptoms of the neuromuscular system. However, ptosis in a patient with hypothyroidism is very rare. We report here on a case of central hypothyroidism that was due to Sheehan's syndrome and it manifested as bilateral ptosis in a 51-yr-old woman. She complained of exertional dyspnea and weakness. About 25-yr ago, she had a history of severe postpartum vaginal bleeding. The laboratory studies demonstrated hypopituitarism with secondary hypothyroidism. The ptosis was improved by replacement of thyroid hormone. Hypothyroidism should be considered in the differential diagnosis of patients who manifest with ptosis and that prompt replacement of hormone can lead to a complete recovery.
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PMID:A case of Sheehan's syndrome that manifested as bilateral ptosis. 2146 69

While minimally invasive approaches are used routinely to correct severe mitral regurgitation due to leaflet prolapse, isolated tricuspid valve prolapse is less frequent and usually addressed via sternotomy. A 34-year-old female presented with exertional dyspnea and severe tricuspid regurgitation due to an unsupported anterior leaflet causing prolapse, a tethered septal leaflet, and dilated annulus. Herein, the technique is described of a robot-assisted tricuspid valve repair using established open valvuloplasty principles. The robotic repair was performed by the placement of Gore-Tex neochordae from the anterior papillary muscle to the anterior tricuspid leaflet, plication of the anteroseptal and anteroposterior commissures, closure of an anterior leaflet cleft, and the insertion of an annuloplasty band. The patient had an uncomplicated hospital course and was dismissed home on the third postoperative day.
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PMID:Robot-assisted repair of tricuspid leaflet prolapse using standard valvuloplasty techniques. 2340 56

Traumatic tricuspid regurgitation (TR) is a rare cardiovascular complication in chest trauma. Changes in the left ventricle (LV) function after operation are unclear. A 61-year-old woman who had been involved in a traffic accident 1 month earlier presented with exertional dyspnea. Transthoracic echocardiography (TTE) showed severe tricuspid regurgitation (TR) accompanied by LV dysfunction due to anterior leaflet prolapse with papillary muscle rupture. After tricuspid plasty, the LV function improved, as evidenced by TTE and speckle tracking echocardiography. In conclusion, the early diagnosis of traumatic TR is important, and early surgical intervention might be effective for achieving ventricular function improvement.
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PMID:Improvement of the Left Ventricular Function after Tricuspid Valve Plasty for Traumatic Tricuspid Regurgitation. 2978 Jan 43


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