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Recurrent cerebral infarction during anticoagulation therapy in patients with mitral valve prolapse

A Shuaib1, W F Murphy

  • 1Department of Medicine (Neurology), University Hospital, Saskatoon, Saskatchewan, Canada.

Insights

Mitral valve prolapse (MVP) patients can experience cerebral infarction even with anticoagulation. This highlights potential risks and challenges in managing MVP-related cerebrovascular disease.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Mitral valve prolapse (MVP) is linked to increased ischemic event risk.
  • Antiplatelet or anticoagulant therapy typically reduces recurrence.
  • Cerebrovascular disease management in MVP requires careful consideration.

Observation:

  • Two female patients with MVP experienced cerebral infarction despite anticoagulation.
  • Both patients had MVP as a primary risk factor for cerebrovascular disease.

Findings:

  • Extensive, bilateral cerebral infarctions occurred in one patient, leading to death.
  • The second patient suffered three cerebral infarctions, resulting in moderate disability.
  • These cases demonstrate treatment-resistant cerebral infarction in MVP.

Implications:

  • Current anticoagulation strategies may be insufficient for preventing cerebral infarction in select MVP patients.
  • Further research is needed to understand MVP-associated thrombotic mechanisms.
  • This highlights the need for novel therapeutic approaches for cerebrovascular disease in MVP.

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