Mitral valve prolapse

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Mitral valve prolapse

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Mitral valve prolapse

  1. 1. Mitral Valve Prolapse Superior displacement of 1 or both leaflets into the left atrium
  2. 2. Title 1887 • Cuffer and Barbillon described “midsystolic click” 1963 • Barlow and Pocock demonstrated the presence of MR by angiography in patients with the “click-murmur” syndrome 1966 • Criley JM, Lewis KB coined the term MVP in LV angiogram
  3. 3. Epidemiology • M=F in incidence • Incidence :2% • Middle age
  4. 4. Diagnosis Gold standards • Physical examination • 2-dimensional (2D) echocardiography
  5. 5. Only in parasternal long axis view • Single leaflet or bi-leaflet prolapse of at least 2 mm beyond the long axis annular plane, with or without mitral leaflet thickening Prolapse with thickening of the leaflets >5 mm is called classical
  6. 6. Coaptation height • Coaptation height increases with MVP(most commonly affected P2)
  7. 7. Carpentier’s • 3 posterior leaflet scallops- lateral (P1), middle (P2) &medial (P3) • 3 anterior scallops- lateral (A1), middle(A2) & medial (A3) • Most of prolapse involve the posterior middle scallop, which is easily identified on long-axis TTE images[110-120 degree]
  8. 8. MVP syndrome Symptom Signs ECG  Atypical chest pain  Exertional dyspnea Palpitations  Syncope  Anxiety Low blood pressure Thin build  Repolarization abnormalities
  9. 9. Gene map locus • 16p12.1-p11.2 • 11p15.4 • 13.q31.3-q32.1 • Xq28
  10. 10. Clinical Classification primary or nonsyndromic Secondary or syndromic  Marfan syndrome (MFS)  Loeys-dietz syndrome  Ehlers-danlos syndrome  Osteogenesis imperfect  Pseudoxanthoma elasticum  Aneurysmsosteoarthritis syndrome  HCM
  11. 11. Conclusion 1. Fibromyxomatous changes 2. 2% to 3% of the general population 3. Most common valvular pathology requiring surgery 4. Autosomal-dominant nonsyndromic MVP/ rare X-linked 5. Excessive TGF-β signaling 6. Angiotensin I receptor blockade in limiting MVP
  12. 12. Analogy • Senescence is for all like MVP is equal in incidence for male and female

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