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

Abstract

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.

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

“…Carpentier's functional classification of mitral regurgitation (MR) defined MVP (Type II excess leaflet motion) as an anomaly of leaflet motion, where one or different segments of the valve bulge into the LA during systole (1). Classic MVP is defined by >2 mm systolic displacement of one or both mitral valve leaflets into the LA in long-axis view, with a leaflet thickness of ≥5 mm.…”

“…Sudden cardiac death (SCD) is the death from cardiovascular causes, heralded by abrupt loss of consciousness within one hour of the beginning of an acute change in cardiovascular status (1). The term is used when a potentially fatal heart condition (congenital or acquired) was known to be present during life or autopsy has revealed a cardiac or vascular disease as the potential cause of the event.…”

“…In certain situations, the origin is not clear. Therefore, the term ''idiopathic ventricular fibrillation" is adopted (1).…”

“…Mitral valve prolapse (MVP) is characterized by a systolic displacement of one or both mitral leaflets below the mitral annulus plane into the left atrium (LA) (1). 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).…”

“…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).…”