Materiały źródłowe

• #1 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8781541/

  Mitral valve prolapse (MVP) is the most common valvular disease with a prevalence of 2%. […] The diagnosis is made by clinical examination and echocardiography. MVP is the most common valve disease occurring in 1.23% of the general population. […] Transthoracic echocardiography is the first-line imaging modality for the diagnosis of MVP, but also for detecting MAD and hypercontractility, followed by cardiac magnetic resonance for tissue characterization and detection of myocardial and papillary muscle fibrosis. […] A multimodality approach is of paramount importance for the risk stratification of MVP patients. […] The first-line imaging modality for the diagnosis of MVP is transthoracic echocardiography (TTE), which allows assessment of the structural characteristics of the valve. […] Cine magnetic resonance imaging is an adequate tool to study the mitral valvular apparatus as well as thickness and severity of leaflet prolapse and presence of MAD.

• #1 Mitral valve prolapse – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-prolapse/diagnosis-treatment/drc-20355452

  To diagnose mitral valve prolapse, your health care provider will usually do a physical exam and listen to your heart with a stethoscope. […] If you have mitral valve prolapse, a clicking sound may be heard through the stethoscope. If blood is leaking backward through the mitral valve, a whooshing sound (heart murmur) also may be heard. […] Tests that may done to help confirm mitral valve prolapse and evaluate the heart include: […] A standard echocardiogram, also called a transthoracic echocardiogram (TTE), can confirm a diagnosis of mitral valve prolapse and determine its severity. […] Sometimes, a transesophageal echocardiogram (TEE) may be done to get more-detailed images of the mitral valve. […] This test isn’t often used to diagnose mitral valve prolapse, but it can be helpful if other tests haven’t diagnosed the condition.

• #1 Mitral valve prolapse – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-prolapse/diagnosis-treatment/drc-20355452

  Most people with mitral valve prolapse don’t need surgery. But surgery may be recommended if mitral prolapse causes severe mitral valve regurgitation, whether or not you have symptoms. […] For mitral valve prolapse, some basic questions to ask your health care provider include: What tests do I need? […] Your health care provider is likely to ask you questions, such as: Do you always have symptoms or do they come and go?

• #1 Mitral valve prolapse – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/321

  Mitral valve prolapse is the most common cause of chronic mitral regurgitation in developed countries. […] Diagnosis is established by clinical exam and echocardiography. […] MVP with leaflet thickening of 5 mm or greater during diastasis, reflecting myxomatous degeneration, is referred to as classic prolapse and is a predictor of complications. […] The echocardiographic definition of MVP is prolapse of leaflet(s) by 2 mm above the level of the annulus during systole in the long-axis parasternal view. […] Key diagnostic factors include midsystolic click and late-systolic murmur. […] 1st tests to order include echocardiogram.

• #1 Mitral Valve Prolapse (MVP) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-valve-prolapse-mvp

  Mitral valve prolapse (MVP) is usually benign, but complications include mitral regurgitation, endocarditis, and chordal rupture. […] Diagnosis is by physical examination and echocardiography. […] Diagnosis of mitral valve prolapse is suggested clinically and confirmed by echocardiography. Thickened ( 5 mm), redundant mitral valve leaflets are thought to indicate more extensive myxomatous degeneration and greater risk of endocarditis and mitral regurgitation. […] Mitral annular disjunction is diagnosed echocardiographically when frame by frame analysis of the posterolateral annulus in the transthoracic parasternal long axis view reveals systolic separation of the annulus and ventricular myocardium by a few millimeters up to a centimeter. […] Mitral annular disjunction increases the risk of sudden death from arrhythmia, and ambulatory cardiac rhythm monitoring is recommended.

• #1 Mitral Valve Prolapse Workup: Echocardiography, Other Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/155494-workup

  TTE is the most important study for diagnosing mitral valve prolapse (MVP). […] Perloff et al set the stage for accurately diagnosing MVP by expanding the diagnostic standards to include clinical and echocardiographic criteria. […] Echocardiographic findings/diagnostic criteria are as follows: Classic MVP: The parasternal long-axis view shows more than 2 mm superior displacement of the mitral leaflets into the left atrium during systole, with a leaflet thickness of at least 5 mm. […] Nonclassic MVP: Displacement is more than 2 mm, with a maximal leaflet thickness below 5 mm. […] Other echocardiographic findings that should be considered as criteria are leaflet thickening, redundancy, annular dilatation, and chordal elongation. […] 2D-TEE considers several planes of imaging and is thus considered more effective in identifying prolapsing mitral valve segments.

• #1 Mitral valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/diagnosis-treatment/drc-20350183

  To diagnose mitral valve regurgitation, a health care professional does a physical exam and asks questions about your symptoms and medical history. A device called a stethoscope is used to listen to the heart and lungs. If you have mitral valve regurgitation, a whooshing sound called a murmur may be heard. The mitral valve heart murmur is the sound of blood leaking backward through the valve. […] Tests may be done to confirm a diagnosis of mitral valve regurgitation or to check for other conditions that can cause similar symptoms. […] Common tests to diagnose mitral valve regurgitation include: […] Echocardiogram. Sound waves are used to create pictures of the beating heart. An echocardiogram shows the structure of the mitral valve and blood flow in the heart. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It can confirm a diagnosis of mitral valve regurgitation. The test also can tell how severe the condition is. Echocardiography also can help diagnose congenital mitral valve disease, rheumatic mitral valve disease and other heart valve conditions.

• #1 Mitral Valve Prolapse Workup: Echocardiography, Other Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/155494-workup

  3D-TEE, however, can simulate the surgeons view of the mitral valve and has become an essential tool in the intraoperative setting. […] When results from the imaging studies were compared to the „gold standard” of the intraoperative surgical findings, the investigators found the most accurate modality was 3D TEE (96% accurate); the least accurate was with 2D TTE (77% accurate). […] CMRI represents a relatively novel noninvasive imaging method that can identify mitral valve prolapse (MVP) with a sensitivity and specificity of 100%, using 2D transthoracic echocardiography (TTE) as the gold standard. […] CMRI can also serve as an important tool for follow-up of patients with MVP-related moderate to severe mitral regurgitation (MR) for quantitative assessment of ventricular volumes and function.

• #1 How to assess mitral valve prolapse and mitral annular disjunction, how to look for arrhythmogenic features

  https://www.escardio.org/Councils/Council-on-Cardiovascular-Genomics/Cardiovascular-Genomics-Insight/Volume-7/how-to-assess-mitral-valve-prolapse-and-mitral-annular-disjunction-how-to-look

  Mitral valve prolapse (MVP) is characterised by the displacement of one or both mitral valve leaflets during systole, where they move upwards by at least 2 mm above the level of the mitral annulus in the sagittal view (1). […] Cardiovascular imaging plays a crucial role in identifying and characterising the existence of MVP, MAD and the phenotypes of AVMP. Echocardiography and CMR are the most powerful diagnostic techniques not only for the diagnosis but also for stratifying the arrhythmic risk (1). […] The evaluation of MV morphology initiates with two-dimensional (2D) transthoracic Doppler echocardiography (TTE). MVP can be immediately identified and distinguished between myxomatous MVP and fibroelastic deficiency phenotypes (4,5,6). […] The presence of MAD should be detected as well. It may manifest at various locations on the mitral annulus, but it carries an increased risk of VAs when observed at the posterior LV wall.

• #1 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://www.mdpi.com/2077-0383/11/2/455

  Mitral valve prolapse (MVP) is the most common valvular disease with a prevalence of 2%. […] Transthoracic echocardiography is the first-line imaging modality for the diagnosis of MVP, but also for detecting MAD and hypercontractility, followed by cardiac magnetic resonance for tissue characterization and detection of myocardial and papillary muscle fibrosis, using either late gadolinium enhancement (at the basal segment of the inferolateral wall and papillary muscles) (macro-fibrosis), or diffuse fibrosis by T1 mapping (native and post contrast T1). […] The diagnosis is made by clinical examination and echocardiography. MVP is the most common valve disease occurring in 1.2–3% of the general population. […] The renewed interest in MVP derives from anatomo-pathological findings and, more recently, multimodality imaging studies that identified myocardial lesions responsible for c-VA and eventually SCD.

• #1 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8781541/

  CMR can help in stratifying MVP patients at risk for malignant arrhythmias as it allows the detection of either focal or diffuse fibrosis that may be responsible for reentry circuits. […] Multimodality imaging is useful in identifying different MVP phenotypes and can help in therapeutic decision making.

• #1 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://www.mdpi.com/2077-0383/11/2/455

  Echocardiography is the first-line imaging modality for the diagnosis of MVP, which allows assessment of the structural characteristics of the valve, i.e., leaflet thickness, uni- or bileaflet prolapse, prolapse size, presence and severity of MR, left atrial and LV dimension and function. […] Transesophageal echocardiography (TEE) provides the most accurate localization of the pathology, for example, showing which scallop is more involved, chordae rupture, MR severity, MAD length, and 3D TEE is more accurate than 2D TEE for this purpose. […] Cine magnetic resonance imaging is an adequate tool to study the mitral valvular apparatus as well as thickness and severity of leaflet prolapse and presence of MAD. […] CMR can help in stratifying MVP patients at risk for malignant arrhythmias as it allows the detection of either focal or diffuse fibrosis that may be responsible for reentry circuits, providing also evidence of early structural and functional remodeling that may evolve to fibrosis, although these findings need wider clinical investigation.

• #1 How to assess mitral valve prolapse and mitral annular disjunction, how to look for arrhythmogenic features

  https://www.escardio.org/Councils/Council-on-Cardiovascular-Genomics/Cardiovascular-Genomics-Insight/Volume-7/how-to-assess-mitral-valve-prolapse-and-mitral-annular-disjunction-how-to-look

  If uncertainties persist, alternative imaging techniques such as transesophageal echocardiography (TOE), CMR, and stress echocardiography can be employed. […] CMR serves as a pivotal tool in improving the stratification of arrhythmic risk and filling in the gaps in data that may be missing in echocardiography. (8). […] As for echocardiography, it is imperative to document key mitral valve characteristics, including bileaflet MVP and myxomatous MVP. […] A comprehensive evaluation of MAD around the mitral annulus involves acquiring six left ventricular long-axis cine sequences with a 30 interslice rotation. […] Moreover, CMR enables the calculation of MR volume and fraction thanks to phase-contrast velocity mapping sequences (5,6). […] In summary, performing CMR gives pivotal information, but it requires expertise and should be conducted in specialised centres due to its advanced nature.

• #1 Mitral Valve Prolapse | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/m/mitral-valve-prolapse.html

  How is mitral valve prolapse diagnosed? […] You may have no noticeable symptoms. Your healthcare provider may hear a click or murmur during a routine physical exam. The click is created by the snapping sound of the stretched flaps quickly tightening during contraction. The murmur is caused by the blood leaking back into the left atrium. This may be the only sign of MVP. […] Along with a complete health history and physical exam, you may need these tests to diagnose MVP: […] Electrocardiogram (ECG). This test records the strength and timing of the electrical activity of the heart. It shows abnormal rhythms and can sometimes detect heart muscle damage. Small sensors are taped to your skin to pick up the electrical activity. […] Chest X-ray. An X-ray may be done to check your lungs and see if your heart is enlarged.

• #1 Mitral Valve Prolapse | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/m/mitral-valve-prolapse.html

  Transthoracic echocardiogram (echo or TTE). This noninvasive test uses sound waves (ultrasound, sonogram) to evaluate the heart’s chambers and valves. The sound waves create an image on the monitor as a transducer is passed over your chest above the heart. Echocardiography is the most useful diagnostic test for MVP. […] For more severe symptoms, other tests may be done. These may include: […] Transesophageal echocardiogram. This test is a heart ultrasound. It’s done with a camera placed in the esophagus. The camera gets very detailed images of the heart and the mitral valve. […] Stress test. This test is also called a treadmill or exercise ECG. ECG is done while you walk on a treadmill to keep track of the heart during exercise. Breathing and blood pressure rates are also checked. Sometimes a stress test is done with an echocardiogram to detect MVP.

• #1 Mitral Valve Prolapse: Symptoms, Diagnosis, and Treatment

  https://www.healthline.com/health/mitral-valve-prolapse-symptoms

  In some cases, a healthcare professional may recommend a stress test. This test involves you exercising on a treadmill or stationary bike while they monitor your heart rate, blood pressure, and ECG readings. It can help determine how well your heart functions during physical activity. […] A healthcare professional may also suggest a Holter monitor for a more comprehensive assessment. You’ll wear this portable device for 24 to 48 hours, and it continuously records your heart’s electrical activity, noting arrhythmias or other irregularities that may occur.

• #1 Mitral Valve Prolapse and Repair | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/heart-and-vascular/conditions-and-treatments/mitral-valve-prolapse

  Mitral valve prolapse is common. It affects up to 1 in 50 people. Most people do not need treatment because their condition is not serious. […] When you have a heart valve that leaks, your doctor may hear it through a stethoscope. The sound is called a murmur. When your doctor hears a murmur, they will likely suggest you have an echocardiogram. This is a type of imaging that can help your doctor evaluate the valve and many other areas of heart function. […] With an echocardiogram, your doctor can grade the leak. Mitral valve regurgitation is typically graded on a scale from 0 to 4: 0 is no leak or very minor, 1 is a mild leak, 2 is a moderate leak, 3 is a moderate to severe leak, 4 is a severe leak. […] Most patients who need surgery have a grade 4 leak, or in some cases a grade 3. The valve may have a grade 2 leak for years, but it is not loud enough to be heard as a heart murmur.

• #1 Mitral valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/diagnosis-treatment/drc-20350183

  After testing confirms a diagnosis of mitral or other heart valve disease, your health care team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: […] Stage A: At risk. Risk factors for heart valve disease are present. […] Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. […] Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. […] Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #1 Identifying mitral valve prolapse at risk for ventricular arrhythmia and sudden cardiac death: do imaging tools help?

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/identifying-mitral-valve-prolapse-at-risk-for-ventricular-arrhythmia-and-sudden

  While uncomplicated mitral valve prolapse (MVP) presenting with no/trivial mitral regurgitation, and without left atrial/ventricular consequences, enjoys a benign outcome as a group, particular arrhythmic MVP (AMVP) phenotypes are at excess risk of ventricular arrhythmias. […] Phenotypic characterisation requires imaging tools, specifically transthoracic echocardiography, supplemented by cardiac magnetic resonance imaging and computed tomography scan. […] Assessment of ventricular arrhythmia severity by Holter-electrocardiogram (ECG) monitoring is the foundation for risk stratification. […] When diagnosing MVP, it is important to consider an AMVP phenotype. […] MVP diagnosis requires a 24h Holter-ECG arrhythmia assessment. […] Repeated arrhythmia monitoring is required for AMVP phenotypes without severe ventricular arrhythmias at index monitoring.

• #1 Mitral Valve Prolapse Differential Diagnoses

  https://emedicine.medscape.com/article/155494-differential

  Consider all heritable connective tissue disorders mentioned previously, emphasizing Marfan syndrome because of its associated increased frequency with mitral valve prolapse (MVP.) The prevalence of mild mitral valve pathology in Marfan syndrome is estimated to be around 75%. In contrast, the prevalence of severe myxomatous mitral valve thickening with prolapse is closer to 25% in these individuals. […] All causes of mitral regurgitation (MR) should be considered. However, if only a mid-systolic click and/or a mid-to-late systolic murmur is present, the diagnosis is almost always MVP. If only a late systolic murmur without a click is present, papillary muscle dysfunction secondary to coronary artery disease is a possibility. […] Strict diagnostic criteria should be used to prevent the overdiagnosis of MVP. In many patients, MVP was diagnosed on the basis of imprecise echocardiographic criteria, producing undue anxiety, particularly in asymptomatic patients. […] Close follow-up should be undertaken for patients with clinically significant MVP. When clinically significant MR develops or progresses, irreversible left ventricular dysfunction may occur without symptoms. Additionally, endocarditis can be a subtle illness that makes prompt diagnosis difficult.

• #2 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://www.mdpi.com/2077-0383/11/2/455

  Mitral valve prolapse (MVP) is the most common valvular disease with a prevalence of 2%. […] Transthoracic echocardiography is the first-line imaging modality for the diagnosis of MVP, but also for detecting MAD and hypercontractility, followed by cardiac magnetic resonance for tissue characterization and detection of myocardial and papillary muscle fibrosis, using either late gadolinium enhancement (at the basal segment of the inferolateral wall and papillary muscles) (macro-fibrosis), or diffuse fibrosis by T1 mapping (native and post contrast T1). […] The diagnosis is made by clinical examination and echocardiography. MVP is the most common valve disease occurring in 1.2–3% of the general population. […] The renewed interest in MVP derives from anatomo-pathological findings and, more recently, multimodality imaging studies that identified myocardial lesions responsible for c-VA and eventually SCD.

• #2 Mitral Valve Prolapse: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17241-mitral-valve-prolapse

  Mitral valve prolapse (MVP) is a heart issue in which your mitral valve flaps bow or flop back into your left atrium. This may prevent your valve from closing as tightly as it should between your left atrium and left ventricle. […] Healthcare providers diagnose mitral valve disease through a physical exam and tests. A provider can learn a lot by listening to your heart with a stethoscope. If you have mitral valve prolapse, your provider will hear a clicking sound followed by a murmur. Click-murmur syndrome is another name for mitral valve prolapse because of its distinctive sound. […] Echocardiography is the main method providers use to diagnose MVP. This test uses ultrasound technology to check your hearts structure and function. You may need one or both of the following types of this test: Transthoracic echocardiogram. Moving an ultrasound transducer on different areas of your chest provides pictures of your hearts valves and chambers. […] If your provider suspects you have MVP or another valve issue, theyll order at least one test to confirm the diagnosis.

• #2 Mitral Valve Disease and Diagnosis | AdventHealth Orlando

  https://www.adventhealth.com/hospital/adventhealth-orlando/blog/mitral-valve-disease-and-diagnosis

  Mitral valve prolapse (MVP) is the bulging, or prolapse, of one or both of the mitral valve flaps into the left atrium when the heart contracts. Normally the flaps are tightly closed by small cords, or tendons, that connect the flaps to the muscles of the heart. This closure prevents blood from flowing backwards. […] The cause of MVP is unknown, but most cases are thought to be inherited. There are two forms of MVP, primary and secondary. […] MVP may not cause any symptoms, and symptoms that do arise may vary depending on the degree of prolapse present. The presence of symptoms doesn’t necessarily match the severity of MVP. The most common symptoms of MVP are: Fast or irregular heartbeats, known as palpitations; Chest pain; Anxiety; Hyperventilation; Exercise intolerance; Dizziness. […] The symptoms of mitral valve prolapse may look like other medical conditions, so always see a health care provider for an accurate diagnosis.

• #2 Mitral valve prolapse – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/321

  Mitral valve prolapse is the most common cause of chronic mitral regurgitation in developed countries. […] Diagnosis is established by clinical exam and echocardiography. […] MVP with leaflet thickening of 5 mm or greater during diastasis, reflecting myxomatous degeneration, is referred to as classic prolapse and is a predictor of complications. […] The echocardiographic definition of MVP is prolapse of leaflet(s) by 2 mm above the level of the annulus during systole in the long-axis parasternal view. […] Key diagnostic factors include midsystolic click and late-systolic murmur. […] 1st tests to order include echocardiogram.

• #2 Mitral valve prolapse – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/321

  Mitral valve prolapse is the most common cause of chronic mitral regurgitation in developed countries. […] Diagnosis is established by clinical examination and echocardiogram. […] MVP with leaflet thickening of 5 mm or greater during diastasis, reflecting myxomatous degeneration, is referred to as classic prolapse and is a predictor of complications. […] The echocardiographic definition of MVP is prolapse of leaflet(s) by 2 mm above the level of the annulus during systole in the long-axis parasternal view. […] Key diagnostic factors include presence of risk factors, mid-systolic click, and late-systolic murmur. […] 1st investigations to order include echocardiogram.

• #2 Mitral Valve Prolapse Workup: Echocardiography, Other Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/155494-workup

  TTE is the most important study for diagnosing mitral valve prolapse (MVP). […] Perloff et al set the stage for accurately diagnosing MVP by expanding the diagnostic standards to include clinical and echocardiographic criteria. […] Echocardiographic findings/diagnostic criteria are as follows: Classic MVP: The parasternal long-axis view shows more than 2 mm superior displacement of the mitral leaflets into the left atrium during systole, with a leaflet thickness of at least 5 mm. […] Nonclassic MVP: Displacement is more than 2 mm, with a maximal leaflet thickness below 5 mm. […] Other echocardiographic findings that should be considered as criteria are leaflet thickening, redundancy, annular dilatation, and chordal elongation. […] 2D-TEE considers several planes of imaging and is thus considered more effective in identifying prolapsing mitral valve segments.

• #2 Mitral Valve Prolapse | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/m/mitral-valve-prolapse.html

  Transthoracic echocardiogram (echo or TTE). This noninvasive test uses sound waves (ultrasound, sonogram) to evaluate the heart’s chambers and valves. The sound waves create an image on the monitor as a transducer is passed over your chest above the heart. Echocardiography is the most useful diagnostic test for MVP. […] For more severe symptoms, other tests may be done. These may include: […] Transesophageal echocardiogram. This test is a heart ultrasound. It’s done with a camera placed in the esophagus. The camera gets very detailed images of the heart and the mitral valve. […] Stress test. This test is also called a treadmill or exercise ECG. ECG is done while you walk on a treadmill to keep track of the heart during exercise. Breathing and blood pressure rates are also checked. Sometimes a stress test is done with an echocardiogram to detect MVP.

• #2 Mitral valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/diagnosis-treatment/drc-20350183

  Sometimes, a more-detailed echocardiogram is needed to better see the mitral valve. This test is called a transesophageal echocardiogram (TEE). A TEE creates pictures of the heart from inside the body. […] Electrocardiogram (ECG). This test shows how the heart is beating. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. Cardiac MRI may help show the severity of mitral valve regurgitation. […] Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart is checked. […] Cardiac catheterization. This test isn’t often used to diagnose mitral valve disease. But it can be helpful if other tests haven’t diagnosed the condition.

• #2 Making the Diagnosis | Mitral Valve Repair Center

  https://www.mitralvalverepair.org/making-diagnosis

  Essentially, all degenerative mitral valves are repairable. By matching echocardiographic findings to the appropriate surgical skill level required to consistently deliver a repair, valve replacement for degenerative mitral valve disease should be infrequent. […] Two-dimensional and Doppler echocardiography is essential to determine the mechanism (dysfunction) and severity of mitral regurgitation. Assessment of the mitral valve hemodynamics using the ratio of jet to left atrial area, the regurgitant volume (Rvol: the difference between the mitral and aortic stroke volumes) and effective regurgitant orifice (ERO: ratio of regurgitant volume to regurgitant time velocity integral) are useful tools in grading the severity of MR, when integrated with clinical findings. […] Transesophageal echocardiography (TEE) is a useful adjunct to confirm the diagnosis and understand the mechanism of degenerative valve disease in the case of a non-diagnostic transthoracic examination. Experience is also gaining with 3-dimensional echocardiography in the assessment of annular geometry and leaflet dysfunction in the setting of mitral regurgitation, and can be predicted to have a more significant role in planning reparative procedures in the future.

• #2 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://www.mdpi.com/2077-0383/11/2/455

  Echocardiography is the first-line imaging modality for the diagnosis of MVP, which allows assessment of the structural characteristics of the valve, i.e., leaflet thickness, uni- or bileaflet prolapse, prolapse size, presence and severity of MR, left atrial and LV dimension and function. […] Transesophageal echocardiography (TEE) provides the most accurate localization of the pathology, for example, showing which scallop is more involved, chordae rupture, MR severity, MAD length, and 3D TEE is more accurate than 2D TEE for this purpose. […] Cine magnetic resonance imaging is an adequate tool to study the mitral valvular apparatus as well as thickness and severity of leaflet prolapse and presence of MAD. […] CMR can help in stratifying MVP patients at risk for malignant arrhythmias as it allows the detection of either focal or diffuse fibrosis that may be responsible for reentry circuits, providing also evidence of early structural and functional remodeling that may evolve to fibrosis, although these findings need wider clinical investigation.

• #2 Mitral valve prolapse: From new mechanisms to diagnostic challenges | Tessler | Polish Heart Journal (Kardiologia Polska)

  https://journals.viamedica.pl/polish_heart_journal/article/view/KP.a2022.0147/69623

  Transthoracic echocardiography is also the gold standard for assessing the grade of MR severity. […] In recent years, the role of structural imaging is becoming significant as it has the potential to identify patients at risk of complications. […] Cardiac magnetic resonance for MVP evaluation is currently gaining popularity. It can facilitate diagnosis, and with the use of gadolinium, it can offer benefits in better characterizing the tissue, for example detecting myocardial and papillary muscle fibrosis and defining its pattern (macro or diffuse fibrosis).

• #2 Mitral Valve Prolapse: Symptoms, Diagnosis, and Treatment

  https://www.healthline.com/health/mitral-valve-prolapse-symptoms

  In some cases, a healthcare professional may recommend a stress test. This test involves you exercising on a treadmill or stationary bike while they monitor your heart rate, blood pressure, and ECG readings. It can help determine how well your heart functions during physical activity. […] A healthcare professional may also suggest a Holter monitor for a more comprehensive assessment. You’ll wear this portable device for 24 to 48 hours, and it continuously records your heart’s electrical activity, noting arrhythmias or other irregularities that may occur.

• #2 Identifying mitral valve prolapse at risk for ventricular arrhythmia and sudden cardiac death: do imaging tools help?

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/identifying-mitral-valve-prolapse-at-risk-for-ventricular-arrhythmia-and-sudden

  While uncomplicated mitral valve prolapse (MVP) presenting with no/trivial mitral regurgitation, and without left atrial/ventricular consequences, enjoys a benign outcome as a group, particular arrhythmic MVP (AMVP) phenotypes are at excess risk of ventricular arrhythmias. […] Phenotypic characterisation requires imaging tools, specifically transthoracic echocardiography, supplemented by cardiac magnetic resonance imaging and computed tomography scan. […] Assessment of ventricular arrhythmia severity by Holter-electrocardiogram (ECG) monitoring is the foundation for risk stratification. […] When diagnosing MVP, it is important to consider an AMVP phenotype. […] MVP diagnosis requires a 24h Holter-ECG arrhythmia assessment. […] Repeated arrhythmia monitoring is required for AMVP phenotypes without severe ventricular arrhythmias at index monitoring.

• #2 Diagnosing Mitral Valve Disease | NYU Langone Health

  https://nyulangone.org/conditions/mitral-valve-disease/diagnosis

  Chronic mitral valve regurgitation typically progresses slowly. You may have no symptoms for years or decades. Some people receive a diagnosis after a physical exam reveals a heart murmur, in which sounds are heard that may indicate irregular blood flow through the heart. […] Often, people may have severe regurgitation but no symptoms. In these cases, the condition is diagnosed by an echocardiogram. This usually requires treatment to prevent the heart from enlarging or dilating. The major aim of treatment is to give the heart a better chance of returning to a normal size and function. […] After taking a medical history and conducting a physical exam, your NYU Langone specialist may recommend that certain tests be performed before making a diagnosis of mitral valve disease. […] The echocardiogram remains the gold standard imaging technique for diagnosing and quantifying heart valve dysfunction. […] Cardiac catheterization can help your doctor measure the blood flow and pressure on both sides of the mitral valve. This helps the doctor detect problems with the valves ability to regulate blood flow through the heart. It is also used to detect blockages of arteries in the heart.

• #2 Mitral valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/diagnosis-treatment/drc-20350183

  After testing confirms a diagnosis of mitral or other heart valve disease, your health care team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: […] Stage A: At risk. Risk factors for heart valve disease are present. […] Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. […] Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. […] Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #2 Treating mitral valve regurgitation – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/treating-mitral-valve-regurgitation

  Mitral valve regurgitation is the most common type of valvular heart disease in the U.S. The prevalence of the condition increases with age. About 10% of adults over 75 have mitral valve regurgitation. […] Your healthcare team will confirm a diagnosis of mitral valve regurgitation after a thorough exam and testing. This is necessary as other heart conditions can cause similar symptoms to a leaky valve. […] Common tests for mitral valve regurgitation include chest X-ray, cardiac MRI, echocardiogram, electrocardiogram, exercise tests or cardiac catheterization. […] Through testing, your healthcare team may tell you the stage of your disease. The stage of the disease is based on symptoms, severity, structure of the valve and blood flow through the heart. The most appropriate treatment option can be determined through staging.

• #2 Identifying mitral valve prolapse at risk for ventricular arrhythmia and sudden cardiac death: do imaging tools help?

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/identifying-mitral-valve-prolapse-at-risk-for-ventricular-arrhythmia-and-sudden

  AMVP is defined per guidelines as the combination of MVP (with or without MAD), with frequent and/or complex ventricular arrhythmia, in the absence of any other well-defined arrhythmic substrate. […] This phenotype requires careful interpretation of imaging and can also be demonstrated by MRI, which additionally measures the severity and location of myocardial fibrosis. […] Cardiac magnetic resonance imaging (MRI) is useful for arrhythmic risk stratification of MVP, due to its unique ability to identify focal myocardial fibrosis using late gadolinium enhancement (LGE). […] The arrhythmia severity detected by monitoring then guides both frequency of follow-up and therapeutic interventions. […] A clinical/echocardiographic presentation with presyncope or unexplained syncope strongly raises suspicion of an ongoing severe arrhythmia. […] Therefore, the clinical and imaging context strongly influences the intensity of rhythm monitoring. […] Arrhythmia severity by Holter is the main determinant of intensity/frequency of repeated rhythmic screening and of medical/surgical therapy.

• #2 CRITERIA FOR THE DIAGNOSIS OF MITRAL VALVE PROLAPSE.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/jw198802050000007/1988/02/05/criteria-diagnosis-mitral-valve-prolapse

  Echocardiograms are often used to diagnose mitral valve prolapse (MVP) despite a lack of consensus on echocardiographic diagnostic criteria. […] These authors believe that the classic physical signs of MVP (unequivocal mid- to late-systolic click, late systolic apical murmur, or both) are the best independent diagnostic factors. […] The authors recommend any one of the following echocardiographic findings as specific criteria for the diagnosis of MVP: severe bowing of leaflets; coaptation of leaflets on the atrial side of the mitral annulus; moderate to severe Doppler mitral regurgitation with any leaflet bowing; and mild Doppler mitral regurgitation with moderate bowing. […] This study suggests that an echocardiogram should not be done when physical examination clearly demonstrates MVP, and that MVP should be reported as an incidental echocardiographic finding only when strict diagnostic criteria are used.

• #2 Mitral Valve Disease Causes & Diagnosis | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/heart-and-vascular/conditions-and-treatments/mitral-valve-disease/causes-and-diagnoses

  Causes of mitral valve prolapse may include: […] Your cardiologist and/or cardiac surgeon will use imaging tests to help diagnose and classify mitral valve disease. […] Guidelines for the management of patients with valvular heart disease from The American Heart Association/American College of Cardiology (AHA/ACC) suggest routine repeat echocardiography to periodically assess the status of heart valves, even when youre not experiencing symptoms. Changes over time may indicate that its time to reevaluate your medical management protocol or consider surgery.

• #3 Problem: Mitral Valve Prolapse | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-mitral-valve-prolapse

  Mitral valve prolapse, also called MVP, is a condition in which the two valve flaps of the mitral valve don’t close smoothly or evenly, but bulge (prolapse) upward into the left atrium. […] How is mitral valve prolapse detected? Because most patients with MVP don’t have symptoms, a murmur may be detected during a routine physical exam when listening to the heart with a stethoscope. Common symptoms include bursts of rapid heartbeat (palpitations), chest discomfort and fatigue. […] Even for those who aren’t having symptoms, if a murmur is detected suggesting mitral valve prolapse, an echocardiogram (echo) is recommended. The echo uses ultrasound to evaluate the characteristics of the valve cusps and how much blood may be leaking (regurgitation) from the valve when the heart contracts. […] MVP rarely becomes a serious condition. However, in the most serious cases it can cause abnormal heartbeats (arrhythmias) that may eventually become life-threatening. […] When mitral valve prolapse is severe enough to cause significant valve leakage, called “regurgitation,” it can lead to serious complications such as heart attack and stroke.

• #3 Mitral valve prolapse – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_valve_prolapse

  Mitral valve prolapse is a valvular heart disease characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. […] The diagnosis of MVP primarily relies on echocardiography, which uses ultrasound to visualize the mitral valve. […] Echocardiography is the most useful method of diagnosing a prolapsed mitral valve. Two- and three-dimensional echocardiography is particularly valuable as they allow visualization of the mitral leaflets relative to the mitral annulus. This allows measurement of the leaflet thickness and their displacement relative to the annulus. Thickening of the mitral leaflets 5 mm and leaflet displacement 2 mm above the annular plane in parasternal long-axis view indicates classic mitral valve prolapse. […] Diagnosis of mitral valve prolapse is based on modern echocardiographic techniques which can pinpoint abnormal leaflet thickening and other related pathology.

• #3 Mitral valve prolapse – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/mitral-valve-prolapse/

  Mitral valve prolapse (MVP) is caused by a structural defect of the mitral valve that results in mitral leaflets bulging into the left atrium during systole. […] MVP and diagnosis is made with echocardiography. […] Transthoracic echocardiography (test of choice) to confirm diagnosis. […] Echocardiographic definition of MVP: displacement of the mitral valve during systole by more than 2 mm above the mitral valve annulus in the parasternal long-axis view. […] Transesophageal echocardiography (TEE) is used as an adjunct to TTE and intraoperatively to guide mitral valve repair procedures.

• #3 Diagnosis of Mitral Valve Prolapse: Much More than Simple Prolapse. Multimodality Approach to Risk Stratification and Therapeutic Management

  https://www.mdpi.com/2077-0383/11/2/455

  Echocardiography is the first-line imaging modality for the diagnosis of MVP, which allows assessment of the structural characteristics of the valve, i.e., leaflet thickness, uni- or bileaflet prolapse, prolapse size, presence and severity of MR, left atrial and LV dimension and function. […] Transesophageal echocardiography (TEE) provides the most accurate localization of the pathology, for example, showing which scallop is more involved, chordae rupture, MR severity, MAD length, and 3D TEE is more accurate than 2D TEE for this purpose. […] Cine magnetic resonance imaging is an adequate tool to study the mitral valvular apparatus as well as thickness and severity of leaflet prolapse and presence of MAD. […] CMR can help in stratifying MVP patients at risk for malignant arrhythmias as it allows the detection of either focal or diffuse fibrosis that may be responsible for reentry circuits, providing also evidence of early structural and functional remodeling that may evolve to fibrosis, although these findings need wider clinical investigation.

• #3 Mitral Valve Prolapse: Diagnosis & Treatment | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-prolapse/treatment

  Occasionally, your doctor may recommend a more detailed echocardiogram called a transesophageal echocardiogram. This test provides a closer look at the mitral valve and its supporting structures. […] Mitral valve surgery may be the best option for severe cases of mitral valve prolapse with significant mitral valve regurgitation. […] If repair isn’t possible or isn’t the best option, the surgeon may replace your mitral valve with a new one. […] Consult your doctor if you experience symptoms of severe mitral valve prolapse. […] If you need treatment, it’s common for patients who get mitral valve prolapse surgery to live as long as those without valve disorders.

• #3 Identifying mitral valve prolapse at risk for ventricular arrhythmia and sudden cardiac death: do imaging tools help?

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/identifying-mitral-valve-prolapse-at-risk-for-ventricular-arrhythmia-and-sudden

  AMVP is defined per guidelines as the combination of MVP (with or without MAD), with frequent and/or complex ventricular arrhythmia, in the absence of any other well-defined arrhythmic substrate. […] This phenotype requires careful interpretation of imaging and can also be demonstrated by MRI, which additionally measures the severity and location of myocardial fibrosis. […] Cardiac magnetic resonance imaging (MRI) is useful for arrhythmic risk stratification of MVP, due to its unique ability to identify focal myocardial fibrosis using late gadolinium enhancement (LGE). […] The arrhythmia severity detected by monitoring then guides both frequency of follow-up and therapeutic interventions. […] A clinical/echocardiographic presentation with presyncope or unexplained syncope strongly raises suspicion of an ongoing severe arrhythmia. […] Therefore, the clinical and imaging context strongly influences the intensity of rhythm monitoring. […] Arrhythmia severity by Holter is the main determinant of intensity/frequency of repeated rhythmic screening and of medical/surgical therapy.

• #3 Mitral Valve Prolapse | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/m/mitral-valve-prolapse.html

  Cardiac MRI. This imaging test takes detailed pictures of the heart. It may be used to get a more precise look at the heart valves and heart muscle, or to prepare for heart valve surgery. […] Cardiac catheterization. During this procedure, a contrast dye is injected into the heart while X-rays are taken. This procedure can find blockages in the arteries or structural changes in the heart. It’s not used to diagnose MVP. But MVP may be found when a catheterization is done for other reasons.

• #3 Mitral Valve Prolapse and Repair | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/heart-and-vascular/conditions-and-treatments/mitral-valve-prolapse

  Mitral valve prolapse is common. It affects up to 1 in 50 people. Most people do not need treatment because their condition is not serious. […] When you have a heart valve that leaks, your doctor may hear it through a stethoscope. The sound is called a murmur. When your doctor hears a murmur, they will likely suggest you have an echocardiogram. This is a type of imaging that can help your doctor evaluate the valve and many other areas of heart function. […] With an echocardiogram, your doctor can grade the leak. Mitral valve regurgitation is typically graded on a scale from 0 to 4: 0 is no leak or very minor, 1 is a mild leak, 2 is a moderate leak, 3 is a moderate to severe leak, 4 is a severe leak. […] Most patients who need surgery have a grade 4 leak, or in some cases a grade 3. The valve may have a grade 2 leak for years, but it is not loud enough to be heard as a heart murmur.

• #3 Mitral Valve Prolapse by David G. Porzio, M.D. FACC – Marque Medical

  https://marquemedical.com/mitral-valve-prolapse/

  Mitral valve prolapse (MVP) is a very common and often over used diagnosis. […] The diagnosis of MVP requires the application of specific diagnostic criteria in order to accurately make the diagnosis. […] The echocardiogram truly establishes the diagnosis of MVP and even then there are specific criteria that must be present on the study to confirm the presence of MVP. […] Unfortunately, not all cardiologists are familiar with the current exacting criteria required to diagnose MVP and over interpret the echocardiogram and proclaim MVP to be present. […] It has equally been my experience to encounter patients who were told they have MVP by an echocardiogram done many years ago and when I repeat the study and apply the appropriate diagnostic criteria it does not warrant the diagnosis of MVP. […] Establishing the diagnosis of myxomatous mitral valve disease is important in that it requires some degree of monitoring over time as the disease is progressive in nature.

• #3 Mitral valve prolapse: From new mechanisms to diagnostic challenges | Tessler | Polish Heart Journal (Kardiologia Polska)

  https://journals.viamedica.pl/polish_heart_journal/article/view/KP.a2022.0147/69623

  Mitral valve prolapse (MVP) is the most common primary valvular abnormality, associated with various degrees of incompetent function and sequelae, including heart failure and sudden cardiac death. Recent improvements in echocardiographic techniques and new insights into mitral valve anatomy and physiology have rendered the diagnosis of this condition more accurate and reliable. […] The classic physical auscultatory findings of mid-systolic clicks and/or late systolic murmurs are associated with MVP but are not sufficient for diagnosis. […] The first-line and most commonly used imaging modality for MVP is TTE. The seminal work by Robert Levine on the saddle shape of the mitral valve annulus informed the definition of MVP in the American Society of Echocardiography guidelines as displacement of 2 mm or more of the valve leaflets above the annular line in the long-axis view during systole.

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