Grolleau R, Leclercq F L, Carabasse D, Messner P, Fauchier J P
Service de cardiologie A, Hôpital Arnaud-de-Villeneuve, Montpellier.
Arch Mal Coeur Vaiss. 1994 Jan;87(1 Spec No):35-40.
Mitral valve prolapse (MVP) a common condition easily recognised by echocardiography with, however, strict criteria to avoid diagnosis by excess, may be complicated by arrhythmias. Two very different situations oppose severe decompensated mitral regurgitation due to myxoid dystrophy and quasi-asymptomatic MVP with a good prognosis and a low risk of complications. The important question is therefore to detect risk criteria of sudden death in patients with few symptoms. Unfortunately, no isolated factor or association of factors resolves this problem in a given patient. However, it is usually young women without severe mitral regurgitation but with thickened valves and, sometimes, a long QT interval, who are involved. Programmed ventricular stimulation and the detection of later ventricular potentials do not seem to be useful in the present state of our knowledge.
二尖瓣脱垂(MVP)是一种常见病症,通过超声心动图易于识别,然而,为避免过度诊断需遵循严格标准,它可能并发心律失常。两种截然不同的情况形成对比:一方是因黏液样变性导致的严重失代偿性二尖瓣反流,另一方是预后良好且并发症风险低的准无症状MVP。因此,重要的问题是在症状轻微的患者中检测猝死的风险标准。不幸的是,在特定患者中,没有单一因素或因素组合能解决这个问题。然而,通常涉及的是没有严重二尖瓣反流但瓣膜增厚且有时伴有长QT间期的年轻女性。就我们目前的认知状况而言,程控心室刺激和晚期心室电位检测似乎并无用处。