Sudden cardiac arrest as first manifestation of malignant mitral valve prolapse in a young patient: a case report and review of the literature
  • Leila Bigdelu
    Cardiovascular Medicine Division, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Zouheir Bitar
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital-Kuwait Oil Company, Kuwait
  • Ossama Maadarani
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital-Kuwait Oil Company, Kuwait

Keywords

Mitral valve prolapse, malignant phenotype, sudden cardiac death

Abstract

Mitral valve prolapse (MVP) is a primary valvular disease of the mitral valve with a prevalence of 2.4% of the general population. Valve abnormalities range from simple fibroelastic deficiency of the leaflets to diffuse myxomatous degenerative changes. MVP is a usually a benign condition. However, the scattered reports of sudden cardiac death in patients with MVP in the absence of severe mitral insufficiency or coronary artery disease suggest the existence of a malignant phenotype of MVP. We report a case of a young female who survived life-threatening arrhythmias and cardiac arrest and was found to have characteristic features of the malignant phenotype of MVP and had an implantable cardioverter defibrillator as a secondary prevention.

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References

  • Delling FN, Vasan RS. Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis. Circulation 2014;129:2158–2170.
  • Basso C, Iliceto S, Thiene G, Perazzolo, Marra M. Mitral valve prolapse, ventricular arrhythmias, and sudden death. Circulation 2019;140:952-964.
  • Miller MA, Dukkipati SR, Turagam M. Arrhythmic mitral valve pro-lapse: JACC review topic of the week. J Am Coll Cardiol 2018;72:2904-2914.
  • Han HC, Ha FJ, Teh AW. Mitral valve prolapse and sudden cardiac death: A systematic review. JAMA 2018;7: e010584.
  • Muthukumar L, Jahangir A, Jan MF, Perez Moreno AC, Khandheria BK, Tajik AJ. Association Between Malignant Mitral Valve Prolapse and Sudden Cardiac Death: A Review. JAMA Cardiol 2020;5:1053–1061.
  • Syed FF, Ackerman MJ, McLeod CJ, Kapa S, Mulpuru SK, Sriram CS et al. Sites of Successful Ventricular Fibrillation Ablation in Bileaflet Mitral Valve Prolapse Syndrome. Circ Arrhythm Electrophysiol 2016;9:e004005.
  • Nishimura RA, McGoon MD, Shub C, Miller FA Jr, Ilstrup DM, Tajik AJ. Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients. N Engl J Med 1985;313:1305-1309.
  • Sriram CS, Syed FF, Ferguson ME, Johnson JN, Enriquez-Sarano M, Cetta F, et al. Malignant bileaflet mitral valve prolapse syndrome in patients with otherwise idiopathic out-of-hospital cardiac arrest. J Am Coll Cardiol 2013;62:222-230.
  • Garbi M, Lancellotti P, Sheppard MN. Mitral valve and left ventricular features in malignant mitral valve prolapse. Open heart 2018;5:e000925.
  • Levine RA, Hagege AA, Judge DP, Padala M, Dal-Bianco JP, Aikawa E, et al. Mitral valve disease--morphology and mechanisms. Nat Rev Cardiol 2015;12:689-710.
  • Delling FN, Aung S, Vittinghoff E, Dave S, Lim LJ, Olgin JE et al. Antemortem and Post-Mortem Characteristics of Lethal Mitral Valve Prolapse Among All Countywide Sudden Deaths. JACC Clin Electrophysiol 2021;7:1025-1034.
  • Gornick CC, Tobler HG, Pritzker MC, Tuna IC, Almquist A, Benditt DG. Electrophysiologic effects of papillary muscle traction in the intact heart. Circulation 1986;73:1013-1021.
  • Muthukumar L, Rahman F, Jan MF, Shaikh A, Kalvin L, Dhala A et al. The Pickelhaube Sign: Novel Echocardiographic Risk Marker for Malignant Mitral Valve Prolapse Syndrome. JACC Cardiovasc Imaging 2017;10:1078-1080.
  • Essayagh B, Sabbag A, Antoine C, Benfari G, Yang LT, Maalouf J et al. Presentation and Outcome of Arrhythmic Mitral Valve Prolapse. J Am Coll Cardiol 2020;76:637-649.
  • Perazzolo Marra M, Basso C, De Lazzari M, Rizzo S, Cipriani A, Giorgi B et al. Morphofunctional Abnormalities of Mitral Annulus and Arrhythmic Mitral Valve Prolapse. Circ Cardiovasc Imaging 2016;9:e005030.
  • Basso C, Perazzolo Marra M, Rizzo S, De Lazzari M, Giorgi B, Cipriani A et al. Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death. Circulation 2015;132:556–66.
  • Hourdain J, Clavel MA, Deharo JC, Asirvatham S, Avierinos JF, Habib G et al. Common Phenotype in Patients With Mitral Valve Prolapse Who Experienced Sudden Cardiac Death. Circulation 2018;138:1067–1069.

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    Published: 2024-04-03
    Issue: 2024: LATEST ONLINE (view)

    How to cite:
    1.
    Bigdelu L, Bitar Z, Maadarani O. Sudden cardiac arrest as first manifestation of malignant mitral valve prolapse in a young patient: a case report and review of the literature. EJCRIM 2024;11 doi:10.12890/2024_004505.

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