Prevalence of mitral valve prolapse in presumably healthy young men.

Abstract

SUMMARY We determined the prevalence of mitral valve prolapse (MVP) in presumably healthy young men by studying 107 male house officers and medical students with cardiac auscultation in the supine, sitting and standing positions. Echocardiograms were performed at rest in the supine position before and after amyl nitrite inhalation and were obtainable in 101 subjects. Eleven of the 101 subjects had abnormal findings on auscultation: four had an isolated click and seven had a click and late systolic murmur. Correlation of the independent auscultatory and echocardiographic data in the 101 subjects showed that all seven of the subjects with a click and a murmur had echocardiographic evidence of prolapse. None of the 90 subjects with normal auscultation or the four with an isolated click had an abnormal echocardiogram. All seven subjects with MVP had thoracic skeletal abnormalities, but only one was symptomatic. These data suggest that the prevalence of MVP in healthy young males is similar to the reported 6-10% prevalence in healthy young females.THE MITRAL VALVE PROLAPSE SYNDROME was described clinically by Barlow et al." 2 as a midsystolic click and/or late systolic murmur. The clinical spectrum of mitral valve prolapse ranges from normal mitral anatomy and function to severe distortion of leaflet and chordal anatomy with severe mitral regurgitation.Multiple etiological factors contribute to mitral valve prolapse, as indicated by its association with Marfan's syndrome, thoracic skeletal deformities, connective tissue disorders, rheumatic heart disease, decreased left ventricular dimensions as seen in secundum atrial septal defect and aging, hypercontractile states of the ventricle, and coronary artery disease with papillary muscle dysfunction.3-5 Mitral prolapse also occurs in the absence of these related disorders and may be either sporadic or familial.A prevalence figure for mitral valve prolapse in the general population has been difficult to determine, since prevalence depends, in part, on the age, sex, and associated disease processes in the study population. The prevalence figures reported include 1.4% of black South African school children,2 5% in routine autopsies of patients over 40 years of age,6' 7 and 6-10% of presumably normal young women studied by echocardiography.8-10 In this study we assessed the prevalence of mitral valve prolapse in a group of young healthy adult males. MethodsThe study population comprised 107 male house staff and medical students of the Emory University School of Medicine stationed at the Atlanta Veteran's Administration HoQspital over a 3-month period.From Emory University School of Medicine, Department Echocardiograms were done at rest and after amyl nitrite inhalation and were interpreted by two echocardiographers who were unaware of the auscultatory findings. Results AuscultationEleven subjects had a midsystolic click that moved toward the first heart sound after standing. In four of these 11, there was no accompanying systolic murmur.

Mitral valve prolapse: a consistent manifestation of type IV Ehlers-Danlos syndrome. The pathogenetic role of the abnormal production of type III collagen.

“…The echocardiographic findings are summarized in table 1. The M-mode echocardiogram and a simultaneous phonocardiogram from the propositus is shown in figure 1A.…”

Cerebral ischemic events in patients with mitral valve prolapse.

“…Based upon the criteria utilized, mitral valve prolapse may occur in approximately 6% of the young female and a lesser percentage of the young male population. [1][2][3][4][5] Many patients are symptom-free, but most have associated chest pain, palpitations, dyspnea, fatigue, and lightheadedness. Although it has generally been regarded as a benign syndrome, four major complications have been recognized: [6][7][8] (1) progressive mitral regurgitation, (2) spontaneous rupture of the chorda tendineae, (3) sudden death believed due to ventricular fibrillation (occurring in 1.2 to 1.6%), and (4) bacterial endocarditis (which occurs in 3% of patients).…”

Prevalence of mitral valve prolapse in presumably healthy korean adults

“…In fact, mitral valve prolapse has been suggested to be a form of developmental connective tissue disorder (Salomon et al, 1975;Udoshi et al, 1979). This crosssectional survey demonstrated a relatively low prevalence of mitral valve prolapse compared with previous observations (Darsee et al, 1978;Markiewicz et al, 1976;Sbarbaro et al, 1979). Variance in somatic features among ethnic groups may explain this difference in its prevalence.…”

“…Although significant clinical *Presented in part at the IX World Congress of Cardiology in Moscow, USSR, June 1982. manifestations may be present in this syndrome, a high incidence of asymptomatic cases have been reported (Brown et al, 1975;Darsee et al, 1978;Markiewicz et al, 1976;Sbarbaro et al, 1979).…”