How Many Clues Make an evidence? An Unusual Case of Aborted Cardiac Arrest Due to Mitral Valve Prolapse

Abstract

There is an increasing awareness on the association between mitral valve prolapse (MVP) and sudden cardiac death. Mitral annular disjunction (MAD) is a phenotypic risk feature that can help in risk stratification. We present a case of a 58-year-old woman who experienced an out-of-hospital cardiac arrest caused by ventricular fibrillation interrupted by a direct current-shock. No coronary lesions were documented. Echocardiogram showed myxomatous MVP. Nonsustained ventricular tachycardia have been registered during hospital stay. Interestingly, cardiac magnetic resonance revealed MAD and a late gadolinium enhancement area in inferior wall. Finally, a defibrillator has been implanted. For arrhythmic risk stratification of MVP with MAD, multimodality imaging is the diagnostic tool to find out the disease behind many cardiac arrests of unknown cause.

How Imaging Techniques Improve Ventricular Arrhythmia Ablation: A Multimodality-Based Approach

“…Arrhythmogenic mitral valve prolapse is an emerging cause of VAs and sudden death. In this context, the presence of mitral annular disjunction (MAD), curling of the posterior leaflet and moderate-severe mitral regurgitation have been recognized as a marker of VAs risk, again, together with the presence and the extension of non-ischemic scars [26,27].…”