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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
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
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
Related Anatomy
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Related Differential Diagnoses
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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
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
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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