Mitral valve prolapse. Recent concepts and observations

Juan M. Aranda, Benjamin Befeler, Nabil El-Sherif, Agustin Castellanos, Ralph Lazzara

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Abstract

The conditions associated with prolapse of the posterior leaflet of the mitral valve are multiple. The mechanisms of mitral valve prolapse as well as the pathogenesis of pain and ectopic impulse formation are reviewed. Propranolol appears to be the drug of choice for the symptomatic treatment of patients with this syndrome since it decreases myocardial oxygen demand and wall tension thus reducing or abolishing the discrepancy between myocardial oxygen demand and supply within the mitral apparatus. It has also been reported to modify the auscultatory findings associated with this condition. The frequency of this mitral valve abnormality in patients with obstructive coronary artery disease is reviewed. It appears that prolapse of the posterior leaflet scallops in patients with significant obstructive coronary artery disease represents an intermediate stage before mitral insufficiency occurs. This group of patients with papillary muscle dysfunction includes those with prolapsed leaflets without mitral insufficiency, those with systolic murmurs and compensated heart failure and others with progressive cardiac decompensation and severe mitral regurgitation.

Original languageEnglish (US)
Pages (from-to)997-1004
Number of pages8
JournalThe American journal of medicine
Volume60
Issue number7
DOIs
StatePublished - Jun 1976

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aranda, J. M., Befeler, B., El-Sherif, N., Castellanos, A., & Lazzara, R. (1976). Mitral valve prolapse. Recent concepts and observations. The American journal of medicine, 60(7), 997-1004. https://doi.org/10.1016/0002-9343(76)90571-4