11/18. Psychiatric implications of the mitral valve prolapse syndrome (MVPS).The mitral valve prolapse syndrome (MVPS) is an infrequent outcome of mitral valve prolapse, a common and usually benign structural abnormality. Psychiatric patients often present with symptoms indistinguishable from MVPS, knowledge of which is thus essential for differential diagnosis. Even when prolapse of the mitral valve is detected, the symptoms may be variously determined by both physical and emotional factors. Four illustrative case histories are presented.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/18. Mid-systolic click and echocardiographic evidence of mitral valve prolapse during electrical pacing.A mid-systolic click was present in a patient during three years of follow-up after implantation of a permanent transvenous pacemaker. echocardiography revealed posterior motion of the anterior leaflet which resembled mitral valve prolapse. Both the click and echocardiographic evidence of prolapse disappeared simultaneously with resumption of sinus rhythm and during supraventricular tachyarrhythmias. Wtih spontaneous change in the position of the electrode three years after initial implantation, both the click and the posterior motion of the mitral valve disappeared. The association of mitral valve prolapse with electrical pacing is most unusual and appears to have a distinct pathophysiological mechanism.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
13/18. Chaotic echo motion in the left ventricular cavity. Visualization of ruptured chordae tendineae of the mitral valve by real-time two-dimensional echocardiography.The aim of the present study is to perform a detailed analysis of the spot echoes which show chaotic motion of the left ventricular cavity of patients with ruptured chordae tendineae. The subjects were 12 patients with surgically documented ruptured chordae tendineae. They were carefully examined preoperatively by real-time two-dimensional echocardiography with a commercially available wide-angle phased array system (Toshiba SSH-11A). An abnormal moving spot echo was often seen instantaneously in the left ventricle. Its motion was chaotic, and it moved both longitudinally and laterally. Lateral movements were seen in 10 of the 12 subjects and were not found in any of 10 controls. The site of this echo in the left ventricle was identical with the site of the rupture of the mitral chordae confirmed during surgery. Therefore, it was concluded that the spot echo with chaotic motion represents a direct visualization of ruptured chordae. This chaotic motion is considered to be a useful clue in diagnosis. The lateral component (left to right) of the movement is especially important. However, one must carefully examine the left ventricular cavity with moving pictures over a period of many heart beats in order to detect these chaotic movements of spot echoes.- - - - - - - - - - ranking = 8keywords = motion (Clic here for more details about this article) |
14/18. anxiety and mitral valve prolapse syndrome.The diagnosis of mitral valve prolapse syndrome (MVPS), even though symptomatically similar to anxiety neurosis, may prompt pharmacological treatment only, neglecting any underlying emotional problems. If only a dichotomy were considered, one diagnosis might be seen as mutually exclusive of the other. A case history is presented illustrating features of both clinical syndromes. We consider the interaction of both etiologies, as well as the possibility of both being unrelated and coincidental. As physiological factors are explored when the diagnosis of anxiety neurosis is considered, so should psychological factors be examined with MVPS.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
15/18. Mitral annulus calcification, systolic anterior motion of the anterior mitral leaflet and outflow obstruction in two patients without hypertrophic cardiomyopathy. An echocardiographic report.Systolic anterior motion of the anterior mitral leaflet (SAM) and concomitant left ventricular outflow obstruction (LVOFO) are commonly seen in hypertrophic cardiomyopathy. However, SAM has also been described together with extensive anteroseptal wall infarction, pericardial exudation and in hypovolemic situations. This report presents two patients examined with M-mode echocardiography which demonstrates that SAM with LVOFO can also occur in association with mitral annulus calcification (MAC). A possible mechanism behind this entity would firstly be the anterior displacement of the mitral ring commonly seen in MAC. Secondly, extension of calcifications to the posterior wall will furthermore impair the LV contraction leading to loosely stretched chordae tendineae during systole and hence a motion of the anterior mitral valve along the blood stream (SAM) leading to LVOFO.- - - - - - - - - - ranking = 6keywords = motion (Clic here for more details about this article) |
16/18. Echocardiographic source of early anterior systolic motion in late systolic mitral valve prolapse.The echocardiographic features of patients with parachute mitral valve have revealed the combination of an early systolic movement of the mitral valve and late systolic prolapse. Cross-sectional echocardiographic and angiographic studies showed that the early systolic anterior motion was produced by the presence of a flail scallop of the anterior mitral leaflet in the left ventricular outflow tract.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |
17/18. myocardial infarction and coronary ectasia in idiopathipc mitral valve prolapse syndrome.angina pectoris and myocardial infarction occurred in two patients with idiopathic mitral valve prolapse in the absence of atherosclerotic coronary artery disease. Instead, both patients showed the presence of coronary artery ectasia on cineangiography. The anatomic localization of ectasia corresponded with segmental derangement of left ventricular wall motion. Repeated thromboemboli from ectatic vessels and/or locally liberated platelet metabolites were considered the probable mechanism of these symptoms.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
18/18. Septal myectomy for left ventricular outflow tract obstruction after mitral valve repair.We describe a patient with a left ventricular outflow tract obstruction after mitral valve repair. Intraoperative transesophageal echocardiography permitted us to recognize the role of a bulging septum in the development of a systolic motion of the mitral valve. A left ventricular septal myectomy and myotomy was able to relieve the left ventricular outflow tract obstruction and the systolic anterior motion of the mitral valve.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
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