Mitral valve prolapse


#1

#mitral_valve_prolapse
#defination:_
the systolic displacement of an abnormally thickened, redundant mitral leaflet into the left atrium during systole
#MVP_ETIOLOGY
*Mitral valve prolapse (MVP) usually occurs as an isolated entity.
*It also commonly occurs with heritable disorders of connective tissue, including Marfan syndrome, Ehlers-Danlos syndrome, osteogenesis imperfecta, and pseudoxanthoma elasticum.

  • MVP has also been described in association with a secundum atrial septal defect and hypertrophic cardiomyopathy.
    #MVP_Clinical_CLASSIFICATION
    Mitral valve prolapse (MVP) can be categorized into primary or nonsyndromic MVP and secondary or syndromic MVP
    1-.Primary/nonsyndromic MVP
    In the community-based Framingham Heart Study, the prevalence of MVP was2.4%.
    2-Secondary/syndromic MVP
    MVP also occurs in the presence of connective tissue disorders, such as the following :
    Marfan syndrome
    Loeys-Dietz syndrome
    Ehlers-Danlos syndrome
    Osteogenesis imperfecta
    Pseudoxanthoma elasticum
    Aneurysms-osteoarthritis .
    #MVP_CF:
    1_Signs and Symptoms
    *Most patients with MVP are asymptomatic. *Symptoms are related to one of the following:
    _Progression of MR
    _An associated complication (ie, stroke, endocarditis, or arrhythmia)
    Autonomic dysfunction (The association between autonomic dysfunction and MVP remains unconfirmed.)
    2_MVP Symptoms related to progression of MR include:
    *Fatigue
    *Dyspnea
    *Exercise intolerance
    *Orthopnea
    *Paroxysmal nocturnal dyspnea (PND)
    *Progressive signs of chronic heart failure (CHF)
    *Palpitations (from associated arrhythmias)
    3
    #MVP_Symptoms_related_to_autonomic #dysfunction
    *are usually associated with genetically inherited MVP and may include the following:
    *Anxiety
    *Panic attacks
    *Arrhythmias
    *Exercise intolerance
    *Palpitations
    *Atypical chest pain
    *Fatigue
    *Orthostasis
    *Syncope or presyncope
    *Neuropsychiatric symptoms
    4-Common general physical features associated with MVP include the following:
    *Asthenic body habitus
    *Low body weight or BMI
    *Straight-back syndrome
    *Scoliosis or kyphosis
    *Pectus excavatum
    *Hypermobility of the joints
    *Arm span greater than height (which may be indicative of Marfan syndrome
    #Echocardiographc_diagnostic_criteria_of #MVP are as follows:
    1-Classic MVP: The parasternal long-axis view shows more than 2-mm superior displacement of the mitral leaflets into the left atrium during systole, with a leaflet thickness of at least 5 mm.
    2-Nonclassic MVP: Displacement is more than 2 mm, with a maximal leaflet thickness below 5 mm.
    3-Other: Other echocardiographic findings that should be considered as criteria are leaflet thickening, redundancy, annular dilatation, and chordal elongation.
    #complications
    *mitral regurgitation
    *heart failure
    *infective endocarditis
    *Atrial fibrillation
    *thromboembolic stroke
    *sudden cardiac death