[Rupture of the mitral valve chordae. Electrocardiographic, clinical and angiographic findings]. / La rupture de cordages mitraux. Aspects échocardiographiques, cliniques et angiographiques.

This report concerns 9 patients in whom rupture of the cordae of the mitral valve was suspected from the echocardiogram. The authors recall the clinical, echocardiographic, arteriographic, haemodynamic and anatomical findings in patients with rupture of the chordae; they emphasise the importance of echocardiograpy in the pre-operative diagnosis of this condition. In this series, the most frequent clinical sign was a loud pan-systolic murmur at the apex. The electrocardiographic abnormalities were nonspecific. Cardiomegaly was present in most cases. The main echocardiographic findings were those of additional echoes between the two cusps of the mitral valve during diastole, or an abnormally posterior or anterior position of the posterior cusp during diastole, or the presence of mitral prolapse. Other nonspecific signs were frequently present. Left cineangioventriculography showed a significant degree of mitral leakage during diastole in all patients. All 9 patients had an operation or came to post mortem; rupture of the chordae was confirmed in 6 of them. As far as the other 3 cases were concerned, two of them had lengthening of the mitral cordae, and the last had mitral prolapse associated with endocardial vegetation. A further group of 60 patients undergoing surgery for mitral incompetence without rupture of the chordae allowed us to establish that there were no false negative results on the echocardiogram.