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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
Published on: May 19, 2020
Mitral valve billowing and prolapse: perspective at 25 years
1Department of Cardiology, University of the Witwatersrand, Johannesburg, South Africa.
Herz
|August 1, 1988
Summary
Mitral valve prolapse, a condition linked to myxomatous degeneration, can cause clicks or murmurs. While often benign, severe cases may require surgery, with leaflet edge prolapse carrying higher complication risks.
Area of Science:
- Cardiology
- Valvular Heart Disease
Background:
- Primary mitral leaflet billow with or without prolapse is linked to myxomatous degeneration, primarily of the posterior leaflet, and can be familial.
- Clinical presentation includes nonejection systolic click (billow), late systolic murmur (prolapse), or both.
- Associated symptoms encompass anxiety, chest pain, and palpitations, with potential ECG abnormalities.
Purpose of the Study:
- To describe the clinical features, diagnostic challenges, and management of mitral leaflet billow and prolapse.
- To differentiate between leaflet body billowing and leaflet edge prolapse regarding echocardiographic detection and complication risk.
- To outline the prognosis and treatment strategies for mitral valve prolapse.
Main Methods:
- Clinical observation and patient history.
- Echocardiographic assessment of mitral leaflet morphology and function.
- Review of patient outcomes and treatment responses.
Main Results:
- Echocardiography can assess billowing extent but lacks specific criteria to distinguish normal from pathological billowing.
- Mild leaflet edge prolapse may not be echocardiographically detected, unlike severe prolapse or flail leaflets.
- Patients with leaflet edge prolapse face higher complication risks (emboli, endocarditis, severe regurgitation, arrhythmias, sudden death) than those with leaflet body billowing.
- The majority of patients experience a benign course, requiring only reassurance.
Conclusions:
- Mitral leaflet billow and prolapse, often associated with myxomatous degeneration, present with distinct clinical signs.
- Echocardiography has limitations in detecting mild prolapse, highlighting the importance of clinical assessment.
- Management depends on severity and complications, with surgery indicated for severe regurgitation or refractory arrhythmias.
- Prognosis is generally favorable but influenced by the presence and severity of prolapse and underlying conditions.
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