mitral valve prolapse

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Mitral valve prolapse (MVP), also known as Barlow syndrome, is often defined as systolic bowing of the mitral leaflet more than 2 mm beyond the annular plane into the atrium . It is a common cause of mitral regurgitation (considered most frequent cause of severe non-ischemic mitral regurgitation).

Epidemiology

Mitral valve prolapse may affect up to 2-3% of the general population . Although often isolated it is also seen in individuals with connective tissue disorders. Another important association is adult polycystic kidney disease.

Clinical presentation

Mitral valve prolapse is often asymptomatic, however some patients may experience atypical chest pain and palpitations. On cardiac auscultation, a characteristic late systolic murmur with mid-systolic click may be audible in the mitral region.

Pathology

Mitral leaflet bowing is caused by rupture or elongation of the chordae tendineae (often due to myxomatous degeneration). The middle scallop of the posterior leaflet (P2 segment) is most often affected.

Radiographic features

Ultrasound / echocardiography

In mitral valve prolapse, the coaptation line lies behind the annular plane. On 2D echo, the diagnosis of a prolapse should be made in the parasternal or eventually the apical long-axis view and not on an apical four-chamber view, as the saddle shaped annulus could lead to a false positive diagnosis .

Treatment and prognosis

It is usually repaired surgically.