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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For a large proportion of children suffering a stroke, no specific cause can be found. Two cases with infantile hemiplegia are reported who subsequently were found to have mitral valve prolapse, which occurred as a familial trait in both cases. An association between stroke in childhood and mitral valve prolapse is suggested.
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PMID:Mitral valve prolapse: a cause of stroke in children? 725 May 44

M-mode and two-dimensional echocardiography were performed to investigate the motion of the interventricular septum (IVS) and posterior wall (PW) in cases with pure mitral (MI) or aortic (AI) insufficiency. Subjects were classified into four groups; 15 cases with chorda rupture or floppy mitral valve (acute MI), four with AI of acute onset (acute AI), 17 with chronic MI including rheumatic MI, mitral valve prolapse syndrome, and 11 with chronic AI. There wee no differences of left ventricular dimension (LVDI), stroke volume (SV), ejection fraction (EF) and cardiac output (CI) between acute and chronic MI, and between acute and chronic AI, although LVDI and CI were increased in all groups. The ratio of the amplitude of IVS to PW excursion was significantly increased in cases with LV dilation due to acute MI or AI, compared with that in chronic MI or AI. This ratio had a linear relationship with LVDI in acute volume overload, but in chronic volume overload, it was constantly 1.0 or less. The mechanism of the increased septal motion in acute MI or AI is still unknown, but it appears to reflect the intact and contractile septum which adapts to volume overload more readily than the posterior wall. It is probably because the posterior wall is prevented from distension by the pericardium. On the other hand, in chronic MI or AI, vigorous septal motion would not be observed because of the occasional presence of relative tricuspid insufficiency, the effects of the long standing burden on the septal myocardium, and compensatory distension of the posterior wall and pericardium.
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PMID:[Echocardiographic study of left ventricular motion in cases with acute left ventricular diastolic volume overload(author's transl)]. 726 77

In a 27-member family, 8 individuals had mitral valve prolapse (MVP) by echocardiography. Four of them suffered a total of eight cerebral ischemic events in the first four decades of life. In none of these patients could risk factors for stroke, other than MVP, be found. Stroke did not occur in individuals free of MVP. This report draws attention to a previously unrecognized cause of familial stroke which strengthens the relationship between MVP and premature stroke.
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PMID:Familial stroke syndrome associated with mitral valve prolapse. 736 19

Twenty-three patients with ostium-secundum atrial septal defect (ASD) were studied in order to investigate the etiology of angiographic mitral valve prolapse associated with ostium-secundum ASD. 12 patients (52%) had angiograhic MVP. Ventricular volumes, ejection fraction, segmentary contractility and oxygen step-up were analyzed in all patients. Patients with MVP had smaller enddiastolic and stroke volumes (73 +/- 21.8 ml/m2 and 46.6 +/- 18 ml/beat/m2) than patients without MVP (106.6 +/- 22 ml/m2 and 78 +/- 11.3 ml/beat/m2) (P less than 0.01). Oxygen step-up was greater in patients with MVP (P less than 0.05). No consistent differences in ejection fraction and segmentary contractility were found. Our findings suggest that angiographic MVP associated with ostium-secundum ASD is a functional disorder due to reduced left ventricular enddiastolic volume secondary to the atrial shunt.
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PMID:The role of reduced left ventricular enddiastolic volume in the apparently high prevalence of mitral valve prolapse in atrial septal defect. 739 25

The clinical and laboratory features of 24 patients with proven mitral valve prolapse (MVP) and brain dysfunction are reported. The age range of affected patients was between 20 and 63 years (average of 43) and 70 percent were women. MVP was documented prior to the brain illness in only 4 patients. The majority of patients experienced bland cerebral infarction. Disorders also included transient ischemic attacks, cerebellar infarctions, parencymatous and subarachnoid hemorrhage, seizures and retinal artery occlusion. Significant risk factors for stroke other than MVP were lacking in the patient group. Cerebral angiograms occasionally showed distal occlusions of small arteries suggesting embolic brain lesions. Our study suggests that MVP is a risk factor for stroke. We recommend echocardiography in patients with cerebral ischemia who lack clear, recognized risk factors for stroke. We believe the basis for this brain disorder to be emboli from damaged mitral valve leaflets.
Stroke
PMID:Brain events associated with mitral valve prolapse. 742 82

A patient with mitral valve prolapse had two minor strokes after she stopped taking oral anticoagulants. While routine oral anticoagulant therapy is not indicated for mitral valve prolapse, such therapy is strongly recommended when this condition is accompanied by stroke.
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PMID:Stroke as a complication of mitral valve prolapse. 743 99

The radionuclide regurgitant index, defined as left ventricular/right ventricular stroke counts obtained from gated equilibrium studies, has been reported to predict the presence and severity of left-sided valve regurgitation. This study evaluated the radionuclide regurgitant index in 100 patients in whom left-sided valve regurgitation was angiographically graded (0 to 4+) with regard to most severe mitral or aortic regurgitation. Regurgitation was graded 0 in 44 of the 100 patients, 1+ in 22, 2+ in 8, 3+ in 6 and 4+ in 20. The radionuclide regurgitant index was 0.9 to 1.5 in 51 patients, 1.6 to 2.4 in 23 and 2.5 to 12.0 in 26. The mean radionuclide regurgitant index was 1.34 in the group with no regurgitation and 1.60 in those with 1+, 2.01 in those with 2+, 2.80 in those with 3+ and 3.85 in those with 4+ regurgitation. There was a significant difference (p less than 0.05) in the radionuclide regurgitant index between patients with no regurgitation and each group with regurgitation and between groups with regurgitation separated by two or more grades of angiographic regurgitation. Twelve patients had a discordant radionuclide regurgitant index; their index either predicted clinically significant or severe regurgitation when they had no or trivial regurgitation, or predicted no or trivial regurgitation when they had clinically significant regurgitation. Eight of 10 patients with a left ventricular ejection fraction of less than 0.30 had a discordant index (p less than 0.0005). All three patients with mitral valve prolapse associated with frequent ventricular extrasystoles had a discordant index (p less than 0.0005).
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PMID:Radionuclide regurgitant index: value and limitations. 746 80

Twenty consecutive female patients (mean age 30.1 years) with Primary Antiphospholipid Syndrome (PAPS) were studied cardiologically through noninvasive methods and compared with 20 age-and sex-matched healthy subjects. On physical examination 13/20 patients (65%) with PAPS had a valvular abnormality. In 12/20 (60%) patients with PAPS the ECG was abnormal, mainly due to sinus tachycardia in 5 (25%) and acute myocardial infarction in 3 (15%). In 7/20 patients with PAPS (35%) abnormal pulmonary findings were detected by X-ray and in 6 (30%) they were related to dilated pulmonary arch and pulmonary hypertension. In 14/20 cases (70%) with PAPS, abnormal echocardiographic findings were present; 13/20 patients (65%) had valvular complications attributable to PAPS: mitral insufficiency in six cases; mitral valve prolapse in three and aortic insufficiency in three. Two had pulmonary artery hypertension and two, tricuspid regurgitation (one attributable to PAPS). All valve diseases were regurgitant with mild to moderate hemodynamic repercussion. No stenotic lesions were detected. The mean mitral thickness in patients with mitral valve involvement was 7.0 +/- 1.6 mm, compared to 2.8 +/- 0.7 mm in patients with normal valves and 3.1 +/- 0.9 mm in the control group (p < 0.001). The mean aortic valve thickness in patients with aortic valve involvement was 3.6 +/- 0.5 mm compared to 1.5 +/- 0.3 mm in patients with normal valves and 1.4 +/- 0.4 in the control group (p < 0.001). None of the patients from the control group had valve disease (p < 0.0001). Three cases (15%) had pericardial effusion diagnosed by echo. Two patients with PAPS died during the 4.7 +/- 1.2 years of cardiological follow up, due to acute myocardial infarction and embolic cerebrovascular accident, respectively. In conclusion, cardiologic complications are common in PAPS, including left side regurgitant lesions that might be hemodynamically significant, acute myocardial infarction, pericardial effusion and pulmonary hypertension.
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PMID:The heart in the primary antiphospholipid syndrome. 762 Feb 75

Referral-based studies suggest that patients with cerebral ischemia and mitral valve prolapse are prone to recurrent cerebral ischemic events. Our purpose was to determine the risk of subsequent stroke in a population-based group of patients with ischemic stroke or TIA and mitral valve prolapse. From 1975 through 1990, 49 residents of Olmsted County, MN, had an initial ischemic stroke or TIA and echocardiographically diagnosed mitral valve prolapse. Risk of subsequent stroke in this cohort was compared with the age- and sex-adjusted rates of recurrent stroke after initial cerebral ischemia in the Rochester, MN, population. Mean age of the patients was 72 years. Thirty-one (63%) were women. Nine had subsequent stroke (5.5 per 100 person-years). For Rochester patients who had initial ischemic stroke in the period 1975 through 1984, 10.72 recurrent strokes were expected (relative risk, 0.84; 95% confidence limits, 0.38 to 1.59). For Rochester patients with initial ischemic stroke or TIA in the period 1975 through 1979, 12.31 recurrent strokes were expected (relative risk, 0.73; 95% confidence limits, 0.33 to 1.39). There is no evidence of increased subsequent stroke risk among patients with initial episodes of cerebral ischemia and mitral valve prolapse relative to the age- and sex-adjusted recurrent stroke rates in the community.
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PMID:Mitral valve prolapse and the risk of stroke after initial cerebral ischemia. 778 67

Because mitral valve prolapse and patent foramen ovale are supposed to promote stroke in young patients, we assessed the frequency of patent foramen ovale in 18 patients younger than 45 years with stroke and mitral valve prolapse diagnosed on echocardiography at the time of stroke, who were admitted to 2 university hospitals. Eleven patients were called back to hospital for contrast transthoracic and/or transesophageal echocardiography, 3 to 7 years after their initial stroke. A patient foramen ovale was found in 9 patients (50%). In 4 re-assessed patients no mitral valve prolapse was found using our present criteria. Six patients with mitral valve prolapse had a patent foramen ovale (43%). Our results suggest that mitral valve prolapse is commonly associated with patent foramen ovale in young stroke patients.
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PMID:Patent foramen ovale in young stroke patients with mitral valve prolapse. 817 23


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