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Mitral valve prolapse and cerebral ischemic events in young patients
Abstract:
We evaluated 32 young patients with mitral valve prolapse (MVP) as the only recognized cause of cerebral ischemia. The mean follow-up from the time of the first ischemic event was 8 years. At the time of the follow-up evaluation, 24 patients (75%) had a normal cardiac examination, and 4 had midsystolic clicks; only 1 had the characteristic click-murmur. In 75%, the first ischemic event was stroke. When MVP-associated ischemia was recognized, 44% had recurrent ischemic events. In the mean 4-year period between diagnosis of MVP-associated ischemia and follow-up, 16% had recurrent ischemic events, but none had a new persistent deficit from these events. At the time of follow-up, 63% of patients were taking platelet antiaggregants or anticoagulants. These data suggest a good prognosis for recurrent ischemic events after diagnosis of MVP-associated ischemia.
Insights
Mitral valve prolapse (MVP) can cause cerebral ischemia, but prognosis is good. Most patients with MVP-related ischemia showed no new deficits after diagnosis, with many on antiplatelet or anticoagulant therapy.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Mitral valve prolapse (MVP) is identified as a potential cause of cerebral ischemia in young patients.
- Cerebral ischemia in the context of MVP requires further investigation regarding long-term outcomes and prognosis.
Purpose of the Study:
- To evaluate the long-term prognosis of young patients diagnosed with cerebral ischemia attributed to mitral valve prolapse (MVP).
- To assess the incidence of recurrent ischemic events and neurological deficits in this patient cohort.
Main Methods:
- Retrospective evaluation of 32 young patients with MVP as the sole identified cause of cerebral ischemia.
- Mean follow-up period of 8 years post-first ischemic event.
- Assessment of cardiac examination findings, recurrent ischemic events, and medication use (antiplatelet/anticoagulant).
Main Results:
- The majority of patients (75%) exhibited normal cardiac examinations at follow-up; only one had the characteristic click-murmur.
- Stroke was the initial ischemic event in 75% of cases.
- While 44% experienced recurrent ischemic events after MVP-associated ischemia was recognized, only 16% had recurrent events in the 4 years preceding follow-up, with no new persistent deficits reported.
Conclusions:
- Patients diagnosed with MVP-associated cerebral ischemia demonstrate a favorable prognosis regarding recurrent ischemic events.
- The use of antiplatelet or anticoagulant therapy was common (63%) at follow-up, potentially contributing to the good outcomes.
- Long-term follow-up suggests that MVP, even when linked to ischemia, may not portend a poor prognosis for recurrence.