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Brain events associated with mitral valve prolapse
Abstract:
The clinical and laboratory features of 24 patients with proven mitral valve prolapse (MVP) and brain dysfunction are reported. The age range of affected patients was between 20 and 63 years (average of 43) and 70 percent were women. MVP was documented prior to the brain illness in only 4 patients. The majority of patients experienced bland cerebral infarction. Disorders also included transient ischemic attacks, cerebellar infarctions, parencymatous and subarachnoid hemorrhage, seizures and retinal artery occlusion. Significant risk factors for stroke other than MVP were lacking in the patient group. Cerebral angiograms occasionally showed distal occlusions of small arteries suggesting embolic brain lesions. Our study suggests that MVP is a risk factor for stroke. We recommend echocardiography in patients with cerebral ischemia who lack clear, recognized risk factors for stroke. We believe the basis for this brain disorder to be emboli from damaged mitral valve leaflets.
Insights
Mitral valve prolapse (MVP) is a risk factor for stroke, particularly in women. Echocardiography is recommended for patients with unexplained cerebral ischemia to identify potential MVP.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Mitral valve prolapse (MVP) is a common valvular heart condition.
- Brain dysfunction can manifest in various neurological disorders.
- The link between MVP and cerebrovascular events requires further investigation.
Purpose of the Study:
- To investigate the clinical and laboratory features of patients with both mitral valve prolapse and brain dysfunction.
- To determine if MVP is a significant risk factor for stroke in patients lacking other common risk factors.
Main Methods:
- Retrospective analysis of 24 patients diagnosed with mitral valve prolapse and concurrent brain dysfunction.
- Review of clinical presentations, laboratory findings, and neuroimaging results (including cerebral angiograms).
Main Results:
- The majority of affected patients were women (70%) aged 20-63 years (average 43).
- Cerebral infarction was the most common neurological event, followed by transient ischemic attacks, hemorrhages, and seizures.
- MVP was diagnosed prior to neurological symptoms in only 4 patients, suggesting a potential underdiagnosis or delayed recognition.
- Cerebral angiograms indicated distal occlusions, consistent with embolic phenomena.
Conclusions:
- Mitral valve prolapse is identified as a potential risk factor for stroke.
- Emboli originating from damaged mitral valve leaflets are hypothesized as the cause of brain lesions.
- Echocardiography is recommended for patients presenting with cerebral ischemia without other identifiable stroke risk factors.