Document Detail

Mitral valve billowing and prolapse--an overview.
MedLine Citation:
PMID:  1449436     Owner:  NLM     Status:  MEDLINE    
Three decades after it was demonstrated that nonejection systolic clicks and late systolic murmurs have a mitral valve origin and that a specific syndrome is associated with the primary degenerative mitral lesion, numerous questions remain unanswered. A principal cause of confusion is the use of the term 'prolapse', which essentially implies a pathological state, in many patients with minimal evidence of a mitral valve anomaly. It should be recognised that no specific feature, whether evaluated by high standard echocardiography or indeed by careful morphological and histological examination, can be defined which distinguishes a normal variant from a pathological valve. There is a gradation from the normal billowing during ventricular systole of mitral leaflet bodies to marked billowing. With advanced billowing or floppy leaflets, failure of leaflet edge apposition supervenes (true prolapse). This is functionally abnormal and allows mitral regurgitation. Prolapse in turn may progress to a flail leaflet and hence gross regurgitation. Relatively rare complications of this degenerative mitral valve anomaly include systemic emboli, infective endocarditis, arrhythmias and, arguably, autonomic nervous system abnormalities. An attempt is made to clarify the management of some symptoms and other aspects of mitral prolapse-including rheumatic anterior leaflet prolapse (without billowing) which remains prevalent in South Africa and Third World countries.
J B Barlow
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Australian and New Zealand journal of medicine     Volume:  22     ISSN:  0004-8291     ISO Abbreviation:  Aust N Z J Med     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-12-30     Completed Date:  1992-12-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1264322     Medline TA:  Aust N Z J Med     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  541-9     Citation Subset:  IM    
Department of Cardiology, University of the Witwatersand, Parktown, South Africa.
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MeSH Terms
Arrhythmias, Cardiac / complications
Death, Sudden, Cardiac / etiology
Mitral Valve Insufficiency* / complications,  surgery
Mitral Valve Prolapse* / complications,  ultrasonography

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