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Related Experiment Videos

Strokes: A complication of mitral-leaflet prolapse?

W J Kostuk, D R Boughner, H J Barnett

    Lancet (London, England)
    |August 13, 1977
    PubMed
    Summary

    Patients with transient ischemic attacks (TIAs) and normal angiograms often have mitral valve prolapse. This condition may cause embolic events, leading to neurological dysfunction and stroke-like symptoms.

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    Area of Science:

    • Cardiology
    • Neurology
    • Vascular Medicine

    Background:

    • Transient ischemic attacks (TIAs) are often investigated for underlying vascular causes.
    • Normal cerebral angiograms in TIA patients can present a diagnostic challenge.
    • Mitral valve prolapse is a common cardiac condition with potential systemic implications.

    Purpose of the Study:

    • To investigate the potential link between mitral valve prolapse and TIAs in patients with normal cerebral angiograms.
    • To identify the source of embolic events in patients experiencing recurrent neurological dysfunction without significant atheromatous disease.

    Main Methods:

    • Prospective trial involving 14 patients with TIAs and normal cerebral angiograms.
    • Clinical examination including auscultation for cardiac murmurs and clicks.
    • Holter electrocardiographic monitoring for arrhythmias.
    • Left ventricular angiography to assess for mitral valve prolapse.
    • Review of patient history for neurological episodes.

    Main Results:

    • All 14 patients exhibited mitral valve prolapse confirmed by left ventricular angiography.
    • Neurological episodes were characterized as acute, non-progressive strokes with residual symptoms.
    • Cardiac abnormalities including mid-systolic clicks and systolic murmurs were present in several patients.
    • Electrocardiographic monitoring revealed various cardiac arrhythmias.
    • Cerebral angiograms showed no significant intracranial or extracranial atheromatous disease.

    Conclusions:

    • Mitral valve prolapse is a likely source of embolic events causing TIAs in patients with normal cerebral angiograms.
    • The abnormal mitral valve can lead to the formation of emboli, resulting in focal neurological deficits.
    • Further investigation into cardiac causes, particularly valvular abnormalities, is crucial for patients presenting with unexplained TIAs.

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