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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
- Mitral valve prolapse (MVP)
Definitions
- MVP: Systolic extension of mitral valve leaflets > 2 mm into left atrium
- 2 main forms
- "Billowing" leaflet: Entire leaflet or portion of leaflet bows posteriorly into left atrium > 2 mm beyond mitral annular plane; tips of leaflets remain in left ventricle
- "Flail" leaflet: Chordal rupture to portion of leaflet allows retrograde extension of free edge of leaflet into left atrium
- 2 main forms
- Mitral regurgitation: Systolic retrograde flow of blood from left ventricle into left atrium
- Myxomatous mitral valve disease: Inflammatory and infiltrative disease of mitral valve
- Involves excess collagen and proteoglycan deposition in valve tissue
- Results in edematous leaflet thickening, elongation, redundancy, and dysfunction
- Most common cause of mitral prolapse and regurgitation requiring surgery in Western world
- a.k.a. Barlow syndrome or floppy valve disease
- MVP: Systolic extension of mitral valve leaflets > 2 mm into left atrium
IMAGING
General Features
Radiographic Findings
CT Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Althunayyan A et al: Mitral valve prolapse. Expert Rev Cardiovasc Ther. ePub, 2018
- Doherty JU et al: ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 70(13):1647-2, 2017
- Edwards NC et al: Quantification of left ventricular interstitial fibrosis in asymptomatic chronic primary degenerative mitral regurgitation. Circ Cardiovasc Imaging. 7(6):946-53, 2014
- Guy TS et al: Mitral valve prolapse. Annu Rev Med. 63:277-92, 2012
- Morris MF et al: CT and MR imaging of the mitral valve: radiologic-pathologic correlation. Radiographics. 30(6):1603-20, 2010
- Han Y et al: Cardiovascular magnetic resonance characterization of mitral valve prolapse. JACC Cardiovasc Imaging. 1(3):294-303, 2008
- Grau JB et al: The genetics of mitral valve prolapse. Clin Genet. 72(4):288-95, 2007
- Hepner AD et al: The prevalence of mitral valve prolapse in patients undergoing echocardiography for clinical reason. Int J Cardiol. 2007
- Pinheiro AC et al: Diagnostic value of color flow mapping and Doppler echocardiography in the quantification of mitral regurgitation in patients with mitral valve prolapse or rheumatic heart disease. J Am Soc Echocardiogr. 20(10):1141-8, 2007
- Sharma R et al: The evaluation of real-time 3-dimensional transthoracic echocardiography for the preoperative functional assessment of patients with mitral valve prolapse: a comparison with 2-dimensional transesophageal echocardiography. J Am Soc Echocardiogr. 20(8):934-40, 2007
- Mechleb BK et al: Mitral valve prolapse: relationship of echocardiography characteristics to natural history. Echocardiography. 23(5):434-7, 2006
- Müller S et al: Comparison of three-dimensional imaging to transesophageal echocardiography for preoperative evaluation in mitral valve prolapse. Am J Cardiol. 98(2):243-8, 2006
- Pepi M et al: Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse. J Am Coll Cardiol. 48(12):2524-30, 2006
- Braunwald E: Valvular heart disease. In Braunwald E: Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia: W. B. Saunders Company, 2001
- Becker AE et al: Pathomorphology of mitral valve prolapse. In Boudoulas H et al: Mitral Valve: Floppy Valve, Mitral Valve Prolapse and Mitral Regurgitation. 2nd ed. Armonk, NY: Furuta, 2000
- Boudoulas H et al: Natural history. In Boudoulas H et al: Mitral Valve: Floppy Valve, Mitral Valve Prolapse and Mitral Regurgitation. 2nd ed. Armonk, NY: Furuta, 2000
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
- Mitral valve prolapse (MVP)
Definitions
- MVP: Systolic extension of mitral valve leaflets > 2 mm into left atrium
- 2 main forms
- "Billowing" leaflet: Entire leaflet or portion of leaflet bows posteriorly into left atrium > 2 mm beyond mitral annular plane; tips of leaflets remain in left ventricle
- "Flail" leaflet: Chordal rupture to portion of leaflet allows retrograde extension of free edge of leaflet into left atrium
- 2 main forms
- Mitral regurgitation: Systolic retrograde flow of blood from left ventricle into left atrium
- Myxomatous mitral valve disease: Inflammatory and infiltrative disease of mitral valve
- Involves excess collagen and proteoglycan deposition in valve tissue
- Results in edematous leaflet thickening, elongation, redundancy, and dysfunction
- Most common cause of mitral prolapse and regurgitation requiring surgery in Western world
- a.k.a. Barlow syndrome or floppy valve disease
- MVP: Systolic extension of mitral valve leaflets > 2 mm into left atrium
IMAGING
General Features
Radiographic Findings
CT Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Althunayyan A et al: Mitral valve prolapse. Expert Rev Cardiovasc Ther. ePub, 2018
- Doherty JU et al: ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 70(13):1647-2, 2017
- Edwards NC et al: Quantification of left ventricular interstitial fibrosis in asymptomatic chronic primary degenerative mitral regurgitation. Circ Cardiovasc Imaging. 7(6):946-53, 2014
- Guy TS et al: Mitral valve prolapse. Annu Rev Med. 63:277-92, 2012
- Morris MF et al: CT and MR imaging of the mitral valve: radiologic-pathologic correlation. Radiographics. 30(6):1603-20, 2010
- Han Y et al: Cardiovascular magnetic resonance characterization of mitral valve prolapse. JACC Cardiovasc Imaging. 1(3):294-303, 2008
- Grau JB et al: The genetics of mitral valve prolapse. Clin Genet. 72(4):288-95, 2007
- Hepner AD et al: The prevalence of mitral valve prolapse in patients undergoing echocardiography for clinical reason. Int J Cardiol. 2007
- Pinheiro AC et al: Diagnostic value of color flow mapping and Doppler echocardiography in the quantification of mitral regurgitation in patients with mitral valve prolapse or rheumatic heart disease. J Am Soc Echocardiogr. 20(10):1141-8, 2007
- Sharma R et al: The evaluation of real-time 3-dimensional transthoracic echocardiography for the preoperative functional assessment of patients with mitral valve prolapse: a comparison with 2-dimensional transesophageal echocardiography. J Am Soc Echocardiogr. 20(8):934-40, 2007
- Mechleb BK et al: Mitral valve prolapse: relationship of echocardiography characteristics to natural history. Echocardiography. 23(5):434-7, 2006
- Müller S et al: Comparison of three-dimensional imaging to transesophageal echocardiography for preoperative evaluation in mitral valve prolapse. Am J Cardiol. 98(2):243-8, 2006
- Pepi M et al: Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse. J Am Coll Cardiol. 48(12):2524-30, 2006
- Braunwald E: Valvular heart disease. In Braunwald E: Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia: W. B. Saunders Company, 2001
- Becker AE et al: Pathomorphology of mitral valve prolapse. In Boudoulas H et al: Mitral Valve: Floppy Valve, Mitral Valve Prolapse and Mitral Regurgitation. 2nd ed. Armonk, NY: Furuta, 2000
- Boudoulas H et al: Natural history. In Boudoulas H et al: Mitral Valve: Floppy Valve, Mitral Valve Prolapse and Mitral Regurgitation. 2nd ed. Armonk, NY: Furuta, 2000
