Arrhythmic Mitral Valve Prolapse: Late Correct Diagnosis

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Arrhythmic mitral valve prolapse (AMVP) is an emerging cause of sudden cardiac death.
• Understanding AMVP is critical for diagnosing and managing ventricular arrhythmias.

Observation:

• A 19-year-old female with aborted sudden cardiac death initially diagnosed with idiopathic ventricular fibrillation.
• Progressive decline in left ventricular ejection fraction and recurrent implantable cardioverter defibrillator shocks prompted re-evaluation.
• Detailed cardiac imaging and review of medical history led to a diagnosis of AMVP.

Findings:

• AMVP is associated with left ventricular mechanical dispersion.
• This dispersion increases susceptibility to malignant ventricular arrhythmias.
• Arrhythmia risk is independent of mitral regurgitation severity.

Implications:

• Revisiting past medical records and consulting subspecialists can refine diagnoses.
• Initial diagnoses may evolve with further investigation and follow-up.
• This case highlights the importance of considering AMVP in unexplained arrhythmias.