A 31-year-old woman recently diagnosed with mitral valve prolapse asks about complications of the disease.
Which of the following is the most important determinant of adverse cardiovascular events in this patient?

Question

Quizplus · Accepted Answer

Mitral valve prolapse (MVP) is present in about 2%-3% of the general population, with a slightly higher prevalence in women than men. It is a common cause of mitral regurgitation (MR); however, most patients with MVP have only trace to mild MR, with severe MR noted in <5% of patients at initial diagnosis. Complications associated with MVP include cardiac arrhythmias (atrial or ventricular premature beats, ventricular or supraventricular tachycardia), worsening MR and congestive heart failure, infective endocarditis, and transient ischemic attack or stroke. Most patients with MVP have a risk of cardiovascular morbidity and mortality similar to that of the general population, though moderate to severe MR and LV ejection fraction <50% have been noted in some studies to increase the risk of adverse cardiac events. Other risk factors for cardiovascular morbidity include a left atrium size >40 mm, flail mitral leaflet, atrial fibrillation, and age >50. (Choices A, C, D, and E) Anxiety disorders, nonexertional chest pain, bradycardia, and/or ventricular premature beats have not been associated with adverse cardiovascular events in patients with MVP. Educational objective: Moderate to severe mitral regurgitation and a reduced ejection fraction <50% are associated with increased risk of adverse cardiovascular events in patients with mitral valve prolapse. __________ References: Natural history of asymptomatic mitral valve prolapse in the community. (http://www.ncbi.nlm.nih.gov/pubmed/12221052)

A 31-Year-Old Woman Recently Diagnosed with Mitral Valve Prolapse Asks