[Clinical problems in mitral valve prolapse: an electrocardiographic review].

Electrocardiographic signs of mitral valve prolapse are essentially non-specific. Diagnosis must be based on the other methods, but whenever the diagnosis was established, the electrocardiographic abnormalities may have a certain significance to predict the natural course and prognosis. The reported results and those of our series of 111 cases were compared in detail. Resting and exercise electrocardiography of our series revealed no definite tendency of ST-T changes, arrhythmias and other abnormalities in cases with prolapse except a few signs. When the abnormalities were present, they were not related to the severity of prolapse, but premature ventricular contractions were more frequently observed in severe cases. Atrial fibrillation was observed in higher frequency in cases with mitral regurgitation. The other abnormalities were not conclusive to verify previous studies. When compared to 19 cases with neurocirculatory asthenia comfirmed by clinical tests including angiography, the similarity of electrocardiographic abnormalities was observed in many aspects, but arrhythmias were much more common in cases with mitral valve prolapse. On the other hand, exercise test was positive more frequently in cases with neurocirculatory asthenia. No conclusion was established as to the sites of prolapse and electrocardiographic abnormalities.