#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