Mitral valve prolapse and electrolyte abnormality: a dangerous combination for ventricular arrhythmias

Rajani, Ali Raza; Murugesan, Vagishwari; Baslaib, Fahad; Rafiq, Muhammad Anwer

doi:10.1136/bcr-2014-205055

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…It was initially reported by Barlow in the 1960s as a phenomenon with auscultatory and cine-angiocardiographic findings, before the development of diagnostic echocardiography (1). There are several articles in the literature describing SCD in MVP patients, with a substantial percentage of asymptomatic young individuals (1,(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

et al. 2017

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Mitral valve prolapse (MVP) is a common valve abnormality in general population. Despite the general belief of a benign disorder, several articles since the 1980s report sudden cardiac death (SCD) in MVP patients, with a substantial percentage of asymptomatic young individuals. The problem is to detect those patients at increased risk and implement methods that are suitable to prevent cardiac arrest. This review investigates the correlation between MVP and SCD, the understanding of the pathophysiology, the strategies for detecting those at risk and treatment options. A complete literature survey was performed using PubMed database search to gather available information regarding MVP and SCD. A total of 33 studies met selection criteria for inclusion in the review. MVP is an underrated cause of arrhythmic SCD. The subset of patients with malignant MVP who may be at greater risk for SCD is characterized by young women with bileaflet MVP, biphasic or inverted T waves in the inferior leads, and frequent complex ventricular ectopic activity with documented ventricular bigeminy or ventricular tachycardia (VT) and premature ventricular contractions (PVCs) configurations of outflow tract alternating with fascicular origin or papillary muscle. MVP is a common condition in the general population and is often encountered in asymptomatic individuals. The existing literature continues to generate significant controversy regarding the association of MVP with ventricular arrhythmias and SCD. Early echocardiography and cardiac magnetic resonance (CMR) are essential, as is a greater understanding of the potential electrophysiological processes of primary arrhythmogenesis and the evaluation of the genetic substrate.

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Section: Introductionmentioning

confidence: 99%

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

et al. 2017

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“…Those patients with MVP had higher incidence of ECG abnormalities and VAs ( 42 ). Electrolyte disturbances can be an aggravating factor contributing to the occurrence of VAs and subsequently SCD ( 43 ). Screening programmes, technical availability (ECG, echocardiography) and cost remain obstacles for a wide application of primary prevention.…”

Section: Review Of Sudden Cardiac Arrest With Coexisting Mitral Valvementioning

confidence: 99%

Sudden cardiac arrest and coexisting mitral valve prolapse: a case report and literature review

et al. 2016

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The aetiology of sudden cardiac arrest can often be identified to underlying cardiac pathology. Mitral valve prolapse is a relatively common valvular pathology with symptoms manifesting with increasing severity of mitral regurgitation (MR). It is unusual for severe MR to be present without symptoms, and there is growing evidence that this subset of patients may be at increased risk of sudden cardiac arrest or death. The difficulty lies in identifying those patients at risk and applying measures that are appropriate to halting progression to cardiac arrest. This article examines the association of mitral valve prolapse with cardiac arrests, the underlying pathophysiological process and the strategies for identifying those at risk.

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“…Electrolyte disorders known to cause collapse include hypocalcaemia,1 hypercalcaemia,2 hypokalaemia,3 hyperkalaemia,4 hyponatraemia5 and hypernatraemia 6. However, hypophosphataemia is not commonly associated with collapse, although previous reports associate hypophosphataemia with acute confusion,7 visual hallucinations8 and Wernicke’s encephalopathy 9.…”

Section: Introductionmentioning

confidence: 99%

Hypophosphataemia: an important cause of collapse

Williams¹,

Shrikrishnapalasuriyar

Price

et al. 2018

BMJ Case Reports

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We present a case of a 44-year-old man, civil servant, who presented to the emergency department (ED) following an episode of collapse. He was usually fit and well and while at work he had developed a headache with pins and needles over his face and subsequently collapsed. On arrival to ED, he had a Glasgow Coma Scale (GCS) of 4/15. There was no history of note apart from being prescribed citalopram for depression. Laboratory investigations revealed severe hypophosphataemia (phosphate 0.19 mmol/L) and no other electrolyte abnormality. He was commenced on intravenous phosphate and his GCS improved to 15 within 4 hours. Further investigations revealed no cause for his severe hypophosphataemia and repeat bloods in clinic follow-up showed a normal phosphate level.

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Mitral valve prolapse and electrolyte abnormality: a dangerous combination for ventricular arrhythmias

Cited by 6 publications

References 13 publications

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

Sudden cardiac arrest and coexisting mitral valve prolapse: a case report and literature review

Hypophosphataemia: an important cause of collapse

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