Difference between revisions of "Mitral valve prolapse"

(Background)
 
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*Myxomatous degeneration from [[connective tissue disorder]]
 
*Myxomatous degeneration from [[connective tissue disorder]]
  
==Symptoms==
+
==Clinical Features==
*Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
+
===Symptoms===
 +
*Studies failed to demonstrate that [[chest pain]], [[anxiety]], or [[palpitations]] are associated with MVP
 
*Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
 
*Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
*If progresses to MR, CHF symptoms
+
*If progresses to MR, [[CHF]] symptoms
  
==Physical exam==
+
===Physical exam===
 
*Mid-systolic click
 
*Mid-systolic click
*Late systolic murmur, crescendo into S2
+
*Late systolic [[murmur]], crescendo into S2
*Assoc. with pes excavatum, scoliosis, low body weight, Marfanoid
+
*May have associated physical features:
 +
**Pectus excavatum
 +
**Scoliosis
 +
**Low body weight
 +
**[[Marfan syndrome|Marfanoid]] habitus
 +
 
 +
==Differential Diagnosis==
 +
{{Valvular emergencies DDX}}
  
 
==Evaluation==
 
==Evaluation==
*Echocardiogram
+
===Workup===
 
*[[ECG]] can show nonspecific changes or arrhythmias
 
*[[ECG]] can show nonspecific changes or arrhythmias
 
*[[CXR]] usually normal
 
*[[CXR]] usually normal
 +
*[[Echocardiography]]
  
==Differential Diagnosis==
+
===Diagnosis===
{{Valvular emergencies DDX}}
+
[[File:Mitralinsuff TEE.jpg|thumb|Transesophageal echocardiogram of mitral valve prolapse]]
 +
*Echocardiogram is gold standard
  
 
==Management==
 
==Management==
*Aymptomatic
+
*Asymptomatic
 
**None
 
**None
 
*Symptoms of autonomic dysfunction
 
*Symptoms of autonomic dysfunction
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**Early surgical repair
 
**Early surgical repair
 
*Neuro sequelae
 
*Neuro sequelae
**Rule out [[a-fib]]/ left atrial thrombus, then [[aspirin]] qday
+
**Rule out [[a-fib]]/ left atrial thrombus, then [[aspirin]] daily
 
*Click / Murmur
 
*Click / Murmur
 
**Consider [[endocarditis]]
 
**Consider [[endocarditis]]
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*[[Arrhythmia]]
 
*[[Arrhythmia]]
 
*[[Mitral regurgitation]]
 
*[[Mitral regurgitation]]
 +
 +
==See Also==
  
 
==References==
 
==References==
 
<references/>
 
<references/>
 
*Thakar, B. Mitral Valve Prolapse. Medscape 2015.
 
  
 
[[Category:Cardiology]]
 
[[Category:Cardiology]]

Latest revision as of 15:44, 25 September 2019

Background

  • 1 or more mitral valve leaflets bow into left atrium during systole
  • Most common valve disease in industrial countries (2.4% of pop.)
  • Myxomatous degeneration from connective tissue disorder

Clinical Features

Symptoms

  • Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
  • Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
  • If progresses to MR, CHF symptoms

Physical exam

  • Mid-systolic click
  • Late systolic murmur, crescendo into S2
  • May have associated physical features:
    • Pectus excavatum
    • Scoliosis
    • Low body weight
    • Marfanoid habitus

Differential Diagnosis

Valvular Emergencies

Evaluation

Workup

Diagnosis

Transesophageal echocardiogram of mitral valve prolapse
  • Echocardiogram is gold standard

Management

  • Asymptomatic
    • None
  • Symptoms of autonomic dysfunction
  • Signs of progression to MR
    • Early surgical repair
  • Neuro sequelae
  • Click / Murmur

Complications

See Also

References