Rheumatic mitral valve prolapse

ABSTRACT

To find out the incidence of MVP in patients with well documented history of rheumatic fever with or without rheumatic valvular heart disease, 139 patients and 25 healthy subjects [control group] were enrolled in the present study. Patients were classified clinically into group I patients with only history of rheumatic fever, group II patients with rheumatic M.R., group III patients with rheumatic M.S. group IV A patients with rheumatic combined mitral valve disease and group IVB patients with rheumatic multivavular heart disease. All subjects underwent clinical and echocardiographic examination [M-mode 2-D and Echo-Doppler] MVP was diagnosed on basis of a high threshold recent criteria. It was found that MVP auscultatoryisigns were more prevalent in our patients than other studies which can reflect the role plaved by rheumatic fever in production of this signs. The overall incidence of MVP was 35.3% in patients versus 16% in control group. The incidence was 67.8% in group I, 73.91% group II. 23.53% in group III, 18.18% in group IVA and 4.76% in group IVB. Anterior mitral valve leaflet prolapse and non-ejection clicks were more prevalent in group I, while both leaflets prolapse was more prevalent in group II. The incidence of MVP was higher in mild M.R. while it has no relation to the severity of M.S. Isolated MVP in our country seems to be mostly due to rheumatic affection of the mitral valve leaflets. The entity of rheumatic MVP may be suspected in patients specifically with echocardiographically mitral valve leaflets tips thickening in the presence of history of rheumatic fever. Such group of patients should be managed as rheumatic heart disease patients