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)

The usefulness of pacemaker treatment appears doubtful in patients suffering from syncope of unknown origin after a complete diagnostic evaluation, which includes electrophysiological study. To better assess the effectiveness of this therapy, 24 patients with syncope of unknown origin and negative electrophysiological study were prospectively and alternatively assigned to treatment with pacemaker (group A) vs treatment without pacemaker (group B). Group A included 12 patients (7 males, 5 females) with a mean age of 64 +/- 10 years. No heart disease was present in 7 cases (58%); 3 cases had chronic ischaemic heart disease (25%) and 2 had hypertensive heart disease (17%). The standard ECG was normal in 7 patients, while various conduction abnormalities were observed in the other 5. The mean number of syncopal episodes was 4.8 +/- 3.9 per patient, and the mean between the onset of symptoms and the beginning of this study was 32 +/- 42 months. In these 12 cases a VVI-M pacemaker was implanted, at a programmed rate of 50 or 60 bpm; in three subjects, the pacemaker was of the diagnostic type ("bradycardia event counter"). Group B included 12 patients (8 females, 4 males) with a mean age of 56 +/- 11 years. Organic heart disease was absent in 7 cases (58%); 4 patients showed hypertensive heart disease (33%) and 1 had mitral prolapse (9%). The ECG was normal in 9 subjects. The mean number of syncopes was 3.2 +/- 1.5 per patient; the mean interval since the onset of symptoms was 18 +/- 19 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Syncope of unknown origin after electrophysiologic study: is the treatment with pacemaker useful?]. 218 56

Two cases of sudden death are reported in patients with mitral valve prolapse with mitral insufficiency. Both had significant impairment of left ventricular function. Irreversible ventricular fibrillation occurred in one patient one-half hour preceding a catheterization, whereas the other patient died during sleep. Review of the literature revealed 42 cases of sudden death in patients with prolapse. Occasionally left ventricular dysfunction or medication overdosage can explain or favor development of the terminal arrhythmia, but usually no precipitating factor other than prolapse can be identified. It appears impossible to identify actual subgroups at risk, although sudden death does occur more frequently in patients with a large amount of prolapse of both valves, previous syncopal episodes, and ECG abnormalities at rest. Complex ventricular arrhythmias are also reported, but their predictive importance is difficult to evaluate. Sudden death is a rare complication of mitral prolapse, fact which should conservatively influence indications for further supplementary testing and treatment in these patients.
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PMID:[Sudden death in mitral valve prolapse. Apropos of 2 cases]. 400 89