Systolic flutter of the mitral valve

Area of Science:

• Cardiology
• Infectious Diseases
• Valvular Heart Disease

Background:

• Systolic flutter of the mitral valve is an uncommon echocardiographic finding.
• Mitral regurgitation can result from various etiologies, including mitral valve prolapse, flail leaflets, chordae tendineae rupture, and papillary muscle rupture.
• Bacterial endocarditis is a serious infection that can affect heart valves.

Purpose of the Study:

• To investigate the association between systolic flutter of the mitral valve and bacterial endocarditis.
• To determine the prevalence of systolic flutter in patients with mitral regurgitation from different causes.

Main Methods:

• Retrospective review of echocardiographic findings in patients with systolic flutter of the mitral valve.
• Correlation of echocardiographic findings with clinical history, microbiological data, and pathological evidence of bacterial endocarditis.
• Comparison of the prevalence of systolic flutter in patients with mitral regurgitation due to endocarditis versus other causes.

Main Results:

• Systolic flutter was observed in 11 cases over 3.5 years.
• All 11 patients had mitral regurgitation due to mitral valve prolapse or flail leaflets.
• 82% of these patients had a history of or concurrent bacterial endocarditis.
• Systolic flutter was uncommon (13%) in patients with chordae tendineae or papillary muscle rupture without endocarditis.
• Systolic flutter was not observed in patients with mitral regurgitation from other causes.

Conclusions:

• Systolic flutter of the mitral valve is strongly associated with bacterial endocarditis in the context of mitral regurgitation.
• The regurgitant jet across a structurally abnormal mitral leaflet may contribute to flutter development.
• Endocarditis should be considered in patients presenting with systolic mitral valve flutter and regurgitation.