mitral valve prolapse

Question 1

define

Answer 1

aka barlow syndrome

= commonest valve problem

Question 2

causes/associations

Answer 2

It is usually idiopathic but may be associated with a wide variety of cardiovascular disease and other conditions

Associations

• congenital heart disease: PDA, ASD
• cardiomyopathy
• Turner’s syndrome
• Marfan’s syndrome, Fragile X
• osteogenesis imperfecta
• pseudoxanthoma elasticum
• Wolff-Parkinson White syndrome
• long-QT syndrome
• Ehlers-Danlos Syndrome
• polycystic kidney disease
  *

Answer 3

Features

• patients may complain of atypical chest pain or palpitations
• mid-systolic click (occurs later if patient squatting)
• late systolic murmur (longer if patient standing)
• complications: mitral regurgitation, arrhythmias (including long QT), emboli, sudden death

Question 4

complications:

Answer 4

• mitral regurgitation,
• arrhythmias (including long QT),
• emboli,
• sudden death

Question 5

mx

Answer 5

• symptomatic treatment:
  
  • mild symptoms may respond to reassurance alone
  • beta blockade may produce improvement in patients with chest pain and/or palpitations
• prophylaxis for endocarditis should be given if the patient has a murmur
• antiplatelet therapy is often used as prophylaxis against thromboembolism
• if a patient with mitral valve prolapse has had a ventricular tachyarrhythmia then treatment should be guided by invasive electrophysiological testing