Correlação entre prolapso de vávula mitral e disfunção tireoidiana na população lúpica / Correlation between mitral valve prolapse and thyroid dysfunction in lupus patients

Objetivo: Estudar a prevalência de prolapso de válvula mitral (PVM) em portadores de lúpus eritematoso sistêmico (LES) e a sua possível correlação com disfunção tireoidiana. Métodos: Estudamos 52 portadores de LES (com no mínimo quatro critérios diagnósticos para esta patologia) para função tireoidiana (T3, T4 e TSH) e para prolapso de válvula mitral através da ecocardiografia. Resultados: Encontrou-se uma prevalência de 23,08 por cento de PVM, de 19,23 por cento de hipotireoidismo e de 5,77 por cento de hipertireoidismo. A ocorrência de PVM mostrou-se, de maneira estatisticamente significante, ligada à do hipotireoidismo (p=0,001). Conclusão: concluiu-se que, no LES, o PVM está ligado à ocorrência de hipotireoidismo. Devido à baixa prevalência de hipertireoidismo em nossa população, nenhuma afirmação pode ser feita quanto a esta forma de disfunção

incidence of mitral valve prolapse in patients presenting with atypical chest pain at tertiary care centre in Pakistan

Mitral valve prolapse is the commonest valvular heart disease in western countries. In Pakistan there is paucity of data regarding its prevalence. One important symptom among patients of mitral valve prolapse is atypical chest pain. Most of these patients are labeled functional if no obvious cause for their chest pain is found on initial examination. This prospective study was carried out in Mayo Hospital Lahore to find out the incidence of mitral valve prolapse in patients presenting with atypical chest pain. Case series. Fifty consecutive patients presenting with atypical chest pain in various departments of this hospital were evaluated clinically as well as echocardigraphically for presence of mitral valve prolapse. Out of these fifty patients 13 [26 percent] were found to be suffering from mitral valve prolapse. Six of them were male and seven were females with an average age of 30 years. Mean blood pressure was lower in patients with mitral valve prolapse. 54 percent patients had systolic murmur compared to presence of this feature in 5 percent of those without mitral valve prolapse. Majority of mitral valve prolapse patients complained of fainting and palpitations but none had panic attack or thromboembolism. If high index of suspicion is maintained for diagnosing mitral valve prolapse in patients presenting with atypical chest pain, one quarter of them are found to be suffering from mitral valve prolapse. These patients may be helped by reassurance, giving beta blockers and prophylaxis for infective endocarditis where appropriate

Mitral valve prolapse: two dimensional echocardiography reveals a high prevalence in three to twelve year old children.

The prevalence of mitral valve prolapse (MVP) appears to be age related, MVP being commoner in children as compared to adults. This suggests that asymptomatic MVP may be most frequent in children who are very young. In this study, to better define the prevalence of MVP in young children, we used two dimensional echocardiography and prospectively surveyed 213 healthy urban school children between 3 and 12 years of age. MVP was diagnosed when prolapse of mitral leaflet/s was demonstrated by both two-dimensional and M-mode echocardiography at parasternal long-axis views. Overall, MVP was found in 28 of 213 (13.1%) children. MVP was similarly prevalent in all age groups studied (3-5.9 years: 13 of 83 (13.5%); 6-8.9 years: 9 of 71 (11.2%); and 9-12 years: 6 of 31 (16.2%) children; Chi square = 0.57, p greater than 0.5). Univariate analysis showed that the prevalence of MVP was independent of sex, birth weight, resting heart rate and systolic or diastolic blood pressure. A mid systolic murmur was present in 50.6% of the children although it correlated with echocardiographic diagnosis of MVP in only 39.3%. The left ventricular size or wall thickness and mitral EF and DE slopes were similar in children either with or without MVP. Our results indicate that asymptomatic MVP is frequent in children upto 12 years of age. As a diagnostic test of MVP, presence of apical systolic murmur is considerably inferior to echocardiography. No morphological left ventricular correlates were identified in MVP.

Prolapso de valvula mitral: aspectos epidemiológicos, clínicos y terapéuticos / Mitral valve prolapse: epidemiological, clinic and therapeutic aspects

Estudio prospectivo a largo plazo fue realizado en 145 pacientes con prolapso de la válvula mitral idiopática diagnosticados por criterios clínicos y ecocardiográficos. De ellos 118 eran mujeres y 27 hombres con una relación de 4:1. En rango de edades de 13 a 70 años con un promedio de 32 para el sexo femenino y 31 para el masculino. El estudio incluyó todos los pacientes con prolapso de la válvula mitral secundaria atribuidos a enfermedades o desórdenes establecidos o acompañantes. el promedio de seguimiento era de 2.0 años con rango de 3 meses a 14 años. La condición clínica de los 145 pacientes con insuficiencia mitral presentaron 92 pacientes, en el curso de la evolución 6 casos progresaron a moderada y severa, siendo necesario el reemplazo valvular en un paciente con evolución satisfactoria. La arritmia cardiaca más frecuente encontrada fue la extrasístolia ventricular grado 2-3 de Lown, en dos casos se presentó colgajo de taquicardia ventricular la cual ameritó tratamiento antiarritmico para control de ella. Siete pacientes cursaron con síndrome de pre-excitación: 4 con WOLF Parkinson White tipo A y 3 con Long Ganon Levine, presentando taquicardia supraventricular con conducción aberrante en dos casos, registrados en el electrocardiograma de reposo. En el Holter 2 pacientes presentaron trastornos de conducción: bloqueo de primer grado y bloqueo de segundo grado intermitente. Endocarditis infecciosa se presentó en un paciente que evoluciono satisfactoriamente con tratamiento médico

Mitral Valve Prolapse in Patients with Panic Attacks in Korea

Of 86 Korean patients with recurrent spontaneous panic attacks, not one had definite mitral valve prolapse (MVP). With a very low prevalence of MVP in the general Korean population, this finding suggests that MVP may not be specifically associated with panic attack.