Devereux R B
Department of Medicine, New York Hospital-Cornell Medical Center, New York City.
J Am Med Womens Assoc (1972). 1994 Nov-Dec;49(6):192-7.
Mitral valve prolapse (MVP) is usually a primary, dominantly inherited condition. Diagnosis may be made by auscultation of a midsystolic click and late-systolic murmur that move dynamically with postural maneuvers. Echocardiography confirms the diagnosis by demonstrating M-mode late-systolic prolapse and 2-D leaflet billowing into the left atrium. More severe forms of MVP can be detected echocardiographically by documentation of significant mitral regurgitation, enlargement and thickening of the mitral leaflets and anulus, and loss of leaflet apposition. In contrast to earlier reports, the true "MVP syndrome" consists of low body weight and blood pressure, minor skeletal abnormalities, orthostatic hypotension, palpitations and mitral regurgitation of variable degree. Complications of MVP include progressive mitral regurgitation, infective endocarditis, and possible risk of neurologic ischemia, arrhythmic sudden death, and orthostatic syncope. Risk factors for complications among MVP patients include older age, male gender, the presence of a mitral regurgitant murmur, and, possibly, higher weight and blood pressure. MVP patients with neither a murmur nor Doppler evidence of mitral regurgitation may be reassured that their condition is benign. For other MVP patients, the presence and severity of mitral regurgitation govern the frequency and intensiveness of needed follow-up.
二尖瓣脱垂（MVP）通常是一种原发性、显性遗传疾病。通过听诊收缩中期喀喇音和收缩晚期杂音（其随体位变动而动态变化）可作出诊断。超声心动图通过显示M型收缩晚期脱垂和二维瓣叶膨入左心房来确诊。通过记录明显的二尖瓣反流、二尖瓣叶和瓣环的增大及增厚以及瓣叶对合丧失，超声心动图可检测出更严重形式的MVP。与早期报告不同，真正的“MVP综合征”包括低体重、低血压、轻微骨骼异常、直立性低血压、心悸和不同程度的二尖瓣反流。MVP的并发症包括进行性二尖瓣反流、感染性心内膜炎，以及可能的神经缺血、心律失常性猝死和直立性晕厥风险。MVP患者发生并发症的危险因素包括年龄较大、男性、存在二尖瓣反流杂音，以及可能较高的体重和血压。既无杂音也无二尖瓣反流多普勒证据的MVP患者可放心，其病情为良性。对于其他MVP患者，二尖瓣反流的存在和严重程度决定了所需随访的频率和强度。
