Mitral valve prolapse and transitory cerebral ischemia. Report on 8 cases

Non-complicated mitral valve prolapse (MVP) may cause transitory ischemic attacks (TIA) of a probable micro-embolic nature, especially in young people. This study presents 119 cases of TIA, 41 occurring in patients under 45 years of age. All of the 119 patients were given a brain CT scan and associated risk factors such as dislipidemia, diabetes, arterial hypertension, polycythemia were corrected. In addition, 115 patients underwent an angiography. The 41 patients under 45 were given an echocardiogram. The 8 patients who were found to have mitral valve prolapse were submitted to a 24-hour continuous monitoring of the ECG (Holter test) and only 4 patients were given an angiography. On the basis of the results obtained the Authors propose: (1) to use CT scan and electrocardiograms to study youthful patients who have had one or more events of TIA, (2) not to give them an angiography if they suffer from MVP, (3) to conduct the Holter test on these patients and, (4) to establish a therapy using blood-platelet anti-aggregants. The use of anti-coagulants is debatable, even in cases with recurring events.