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Encyclopedia > Mitral valve prolapse
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Mitral valve prolapse
ICD-10 code: I34.1
ICD-9 code: 394.0, 424.0

Mitral valve prolapse (MVP) is a heart valve condition marked by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. In its nonclassic form, MVP carries a low risk of complications. In severe cases of classic MVP, complications include mitral regurgitation, infective endocarditis, and — in rare circumstances — cardiac arrest usually resulting in sudden death. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... In anatomy, the heart valves are valves in the heart that prevent blood from flowing the wrong way. ... The mitral valve is a valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). ... This page is about the muscular organ, the Heart. ... Systole is the contraction of the chambers of the heart, driving blood out of the chambers. ... Mitral regurgitation (MR), also known as mitral insufficiency, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart. ... Endocarditis is an inflammation of the inner layer of the heart, the endocardium. ... Jump to: navigation, search Death is the cessation of physical life in a living organism or the state of the organism after that event. ...

Contents


Overview

The mitral valve, so named because of its resemblance to a bishop's miter, is the heart valve that prevents the backflow of blood from the left ventricle into the left atrium. It is composed of two leaflets (one anterior, one posterior) that close when the left ventricle contracts. The mitral valve is a valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). ... A bishop is an ordained member of the Christian clergy who, in certain Christian churches, holds a position of authority. ... This article is about the ceremonial head-dress; see also mitre (disambiguation). ... In anatomy, the heart valves are valves in the heart that prevent blood from flowing the wrong way. ... Red blood cells (erythrocytes) are present in the blood and help carry oxygen to the rest of the cells in the body Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). ... In the heart, a ventricle is a chamber which collects blood from an atrium (another heart chamber) and pumps it out of the heart. ... This page is about the muscular organ, the Heart. ...


Each leaflet is composed of three layers of tissue: the atrialis, fibrosa, and spongiosa. Patients with classic mitral valve prolapse have excess connective tissue that thickens the spongiosa and separates collagen bundles in the fibrosa. This weakens the leaflets and adjacent tissue, resulting in increased leaflet area and elongation of the chordae tendineae. Elongation of the chordae often causes rupture, and is commonly found in the chordae tendineae attached to the posterior leaflet. Advanced lesions — also commonly involving the posterior leaflet — lead to leaflet folding, inversion, and displacement toward the left atrium. Biological tissue is a substance made up of cells that perform a similar function. ... Connective tissue is any type of biological tissue with an extensive extracellular matrix and often serves to support, bind together, and protect organs. ... Collagen is the main protein of connective tissue. ... Structure of the Chordae Tendineae Valves like the Tricuspid valve and the Semilunar valves in the heart are attached to the walls of the heart by cord-like tendons called chordae tendineae. ...


History

For many years, mitral valve prolapse was a poorly understood anomaly associated with a wide variety of both related and seemingly unrelated signs and symptoms, including late systolic murmurs, inexplicable panic attacks, and polythelia (extra nipples). Recent studies suggest that these symptoms were incorrectly linked to MVP because the disorder was simply over-diagnosed at the time. Continuously-evolving criteria for diagnosis of MVP with echocardiography made proper diagnosis difficult, and hence many subjects without MVP were included in studies of the disorder and its prevalence. In fact, some modern studies report that as many as 55% of the population would be diagnosed with MVP if older, less reliable methods of MVP diagnosis — notably M-mode echocardiography — were used today. The term mitral valve prolapse was coined by Dr. Michael Criley in 1966 and gained acceptance over the other descriptor of "billowing" of the mitral valve (as described by Dr. Barlow). Systole is the contraction of the chambers of the heart, driving blood out of the chambers. ... The heart sounds are the noises (sound) generated by the beating heart and the resultant flow of blood through it. ... A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than thirty minutes. ... A supernumerary nipple (also known as a third nipple, accessory nipple, polythelia or polymastia) is an additional nipple occuring in mammals including humans. ... Nipple is, generally, the name given to the mammalian nipple,In its most general form a nipple is an appurtenance from which a essence form of fluid emanates in this instance breast milk, to nuture a mothers young. ... An echocardiogram. ...


In recent years, new criteria have been proposed as an objective measure for diagnosis of MVP using more reliable two- and three-dimensional echocardiography. The disorder has also been classified into a number of subtypes with respect to these criteria.


Subtypes

Diagnosis of mitral valve prolapse is based on modern echocardiographic techniques which can pinpoint abnormal leaflet thickening and other related pathology.
Diagnosis of mitral valve prolapse is based on modern echocardiographic techniques which can pinpoint abnormal leaflet thickening and other related pathology.

Prolapsed mitral valves are classified into several subtypes, based on leaflet thickness, concavity, and type of connection to the mitral annulus. Subtypes can be described as classic, nonclassic, symmetric, asymmetric, flail, or non-flail. Mitral valve prolapse - subtypes; pic by Diberri. ... An echocardiogram. ...


Note: all measurments below, refer to adult paitiants and applying them to childeren may be misleading


Classic vs. nonclassic

Prolapse occurs when the mitral valve leaflets are displaced more than 2 mm above the mitral annulus high points. The condition can be further divided into classic and nonclassic subtypes based on the thickness of the mitral valve leaflets: up to 5 mm is considered nonclassic, while anything beyond 5 mm is considered classic MVP. A millimetre (American spelling: millimeter, symbol mm) is an SI unit of length that is equal to one thousandth of a metre. ...


Symmetric vs. asymmetric

Classical prolapse may be subdivided into symmetric and asymmetric, referring to the point at which leaflet tips join the mitral annulus. In symmetric coaptation, leaflet tips meet at a common point on the annulus. Asymmetric coaptation is marked by one leaflet displaced toward the atrium with respect to the other. Patients with asymmetric prolapse are prone to severe deterioration of the mitral valve, with the possible rupture of the chordae tendineae and the development of a flail leaflet.


Flail vs. non-flail

Asymmetric prolapse is further subdivided into flail and non-flail. Flail prolapse occurs when a leaflet tip turns outward, becoming concave toward the left atrium, causing the deterioration of the mitral valve. The severity of flail leaflet varies, ranging from tip eversion to chordal rupture. Dissociation of leaflet and chordae tendineae provides for unrestricted motion of the leaflet (hence "flail leaflet"). Thus patients with flail leaflets have a higher prevalence of mitral regurgitation than those with the non-flail subtype. Mitral regurgitation (MR), also known as mitral insufficiency, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart. ...


Signs and symptoms

Some patients with MVP experience heart palpitations, atrial fibrillation, or syncope, though the prevalence of these symptoms does not differ significantly from the general population. Between 11 and 15 percent of patients experience moderate chest pain and shortness of breath. These symptoms are most likely not caused directly by the prolapsing mitral valve, but rather by the mitral regurgitation that often results from prolapse. A palpitation is an abnormal, rapid beating of the heart, brought on by overexertion, disease or drugs. ... Atrial fibrillation (AF or AFib) is a cardiac arrhythmia (an abnormality of heart rate or rhythm) originating in the atria. ... Fainting or syncope is a sudden (and generally momentary) loss of consciousness due to a lack of sufficient blood and oxygen reaching the brain. ... In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). // Causes Cardiopulmonary Important cardiovascular and... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ...


For unknown reasons, MVP patients tend to have a low body mass index (BMI) and are typically leaner than individuals without MVP. Jump to: navigation, search The body mass index (BMI) is a calculated number, based on height and weight, used to compare and analyse the health effects of body weight on human bodies of all heights. ...


Auscultation

Upon auscultation of an individual with mitral valve prolapse, a mid-systolic click, followed by a late systolic murmur heard best at the apex is common. Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope. ... The heart sounds are the noises (sound) generated by the beating heart and the resultant flow of blood through it. ...


Complications

Mitral regurgitation

Most cases of mitral valve prolapse are associated with mild mitral regurgitation, where blood aberrantly flows from the left ventricle into the left atrium during systole. Approximately 7% of classic MVP patients experience severe regurgitation, often due to chordae tendineae rupture. Mitral regurgitation (MR), also known as mitral insufficiency, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart. ... Systole is the contraction of the chambers of the heart, driving blood out of the chambers. ... Structure of the Chordae Tendineae Valves like the Tricuspid valve and the Semilunar valves in the heart are attached to the walls of the heart by cord-like tendons called chordae tendineae. ...


Sudden death

Severe mitral valve prolapse is associated with arrhythmias and atrial fibrillation that may progress and lead to sudden death. As there is no evidence that a prolapsed valve itself contributes to such arrythmias, these complications are more likely due to mitral regurgitation and congestive heart failure. A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ... Atrial fibrillation (AF or AFib) is a cardiac arrhythmia (an abnormality of heart rate or rhythm) originating in the atria. ... A cardiac arrest is the cessation of normal circulation of the blood due to failure of the ventricles of the heart to contract effectively during systole. ... Jump to: navigation, search Congestive heart failure (CHF) (also called congestive cardiac failure and heart failure) is the inability of the heart to pump a sufficient amount of blood throughout the body, or requiring elevated filling pressures in order to pump effectively. ...


Prognosis

The major predictors of mortality are the severity of mitral regurgitation and the ejection fraction. Patients with moderate to severe mitral regurgitation have a relative risk for mortality that is three times that of the general population. Similarly, a left ventricular ejection fraction at or below 50% carries a relative risk of 3.8. Mitral regurgitation (MR), also known as mitral insufficiency, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart. ... The ejection fraction (EF) or, more correctly, left-ventricular ejection fraction (often abbreviated LVEF) is a measure of how much blood the left ventricle of the heart pumps out with each contraction. ...


Diagnosis

Transthoracic echocardiogram showing prolapse of both leaflets of the mitral valve Transesophagel echocardiogram showing prolapse of both leaflets of the mitral valve

Transthoracic and transesophageal echocardiograms of mitral valve prolapse
Left. A transthoracic echocardiogram displaying prolapse of both the anterior leaflet (AL) and posterior leaflet (PL) of the mitral valve. Right. A transesophageal echocardiogram displaying the heart in the same individual as in the figure to the left. Both figures are during ventricular systole, with the mitral valve closed. AL=Anterior leaflet; PL=Posterior leaflet; LA=Left atrium; LV=Left ventricle; AO=Aorta; Blue line represents the plane of the mitral valve annulus. Download high resolution version (840x580, 211 KB)Transthoracic Echocardiogram of mitral valve prolapse File links The following pages link to this file: Mitral valve prolapse Categories: Images with unknown source ... Download high resolution version (836x574, 205 KB)Transesophageal echocardiogram of mitral valve prolapse File links The following pages link to this file: Mitral valve prolapse Categories: Images with unknown source ... The echocardiogram is an ultrasound of the heart. ... The mitral valve is a valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). ... Systole is the contraction of the chambers of the heart, driving blood out of the chambers. ... The mitral valve is a valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). ...

Echocardiography, a noninvasive method of visualizing the heart, is the most useful method of diagnosing a prolapsed mitral valve. Two- and three-dimensional echocardiography are particularly valuable as they allow visualization of the mitral leaflets relative to the mitral annulus. This allows measurement of the leaflet thickness and their displacement relative to the annulus. Thickening of the mitral leaflets above 2 mm indicates mitral valve prolapse. An echocardiogram. ...


Treatment

Mitral valve prolapse can be treated with surgical replacement of the mitral valve. This may be necessary in as many as 11% of patients with classic MVP, and is indicated for patients with and ejection fraction below 60% and progressive left ventricular dysfunction. The ejection fraction (EF) or, more correctly, left-ventricular ejection fraction (often abbreviated LVEF) is a measure of how much blood the left ventricle of the heart pumps out with each contraction. ...


IE prevention

People with Mitral valve prolapse are at higher risk of Infective endocarditis (that is, bacterial infection of the heart tissue), as a result of surgical operations. Therefore they need preventive antibiotic treatment, before any operation that involves massive bleeding. Minor skin wounds (and plastic surgeries, etc), are not a problem, but dental operations such as pulpectomy ("root canal") are. Thus, as a risk lowering measure, people with Mitral valve prolepse should take extra care of their dental hygiene Endocarditis is an inflammation of the inner layer of the heart, the endocardium. ... An antibiotic is a drug that kills or slows the growth of bacteria. ... Plastic surgery is a general term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. ... Root Canal procedure: unhealthy tooth, drilling, filing with endofile, rubber filling and crown. ...


Prevalence

Figures vary widely, but most recent studies of mitral valve prolapse indicate a prevalence of 1.3% for classic and 1.1% for nonclassic MVP. MVP occurs less frequently in children, and does not vary significantly with sex. Though the reasons are not understood, patients with mitral valve prolapse tend to be leaner with a relatively low body mass index. Jump to: navigation, search The body mass index (BMI) is a calculated number, based on height and weight, used to compare and analyse the health effects of body weight on human bodies of all heights. ...


References

External links

  • Mitral Valve Prolapse - Texas Heart Institute Information Center
  • Mitral Valve Prolapse - Conscious Choice

  Results from FactBites:
 
Mitral valve prolapse - Wikipedia, the free encyclopedia (1266 words)
Mitral valve prolapse (MVP) is a heart valve condition marked by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole.
The mitral valve, so named because of its resemblance to a bishop's miter, is the heart valve that prevents the backflow of blood from the left ventricle into the left atrium.
Patients with asymmetric prolapse are prone to severe deterioration of the mitral valve, with the possible rupture of the chordae tendineae and the development of a flail leaflet.
  More results at FactBites »

 
 

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