[Clinical and echocardiographic symptoms of mitral valve rupture]

The diagnostic sensitivity, specificity and predicting accuracy of the various alterations, established by one-dimensional echocardiography (M-EchoC) were determined in 23 patients with rupture of mitral chordae. The diagnosis of mitral insufficiency, resulting from chordal rupture was confirmed at operation, with angiocardiography and/or bi-dimensional echocardiography. Almost all MEchoC alterations were with a relatively low sensitivity (10-50%), high specificity (60-100%) and moderately high predicting accuracy (50-80%). Of more essential diagnostic significance--moderate sensitivity and high specificity with high predictive accuracy, are the following alterations: systolic fibrillation of mitral valve, diastolic fibrillation of mitral valvular cusps, paradoxical (chaotic) movement of posterior mitral cusp during diastole. Very little sensitivity (10%) but with high specificity (100%) was established in pathological systolic echoes in the cavity of left auricle. In the majority of the cases, the rupture of mitral chordae induced grave mitral regurgitation, conditioning the various stages of cardiac insufficiency. Relatively rare is the light to moderately grave mitral regurgitation with stable hemodynamics and preserved functional capacity.