Mitral Valve Prolapse: Causes, Clinical Manifestations, and Management

作者：Richard B. Devereux, Randi Kramer-Fox, Paul Kligfield · 发表于：Annals of Internal Medicine · 年份：1989 · DOI：10.7326/0003-4819-111-4-305 · 被引用次数：185 · 研究领域：Cardiac Valve Diseases and Treatments、Infective Endocarditis Diagnosis and Management、Phonocardiography and Auscultation Techniques

PURPOSE: To assess the causes, methods of diagnosis, clinical spectrum, and management of mitral valve prolapse. DATA IDENTIFICATION: Results of prospective study of over 800 subjects at Cornell Medical Center from 1979 to the present were used along with studies published from 1963 to 1989 identified by computerized literature searches of Index Medicus and MEDLINE, and by hand searches. STUDY SELECTION: Studies involving controlled design, longitudinal follow-up, or critical assessment of diagnostic methodology, and clinical studies or previous reviews that have contributed most to the understanding of mitral valve prolapse were selected. DATA EXTRACTION: Data concerning the causes, clinical manifestations and complications, and prevalence of mitral valve prolapse, as well as the strength of association between mitral valve prolapse and diagnostic signs, were evaluated and used to develop a practical approach to evaluating and managing patients. RESULTS OF DATA SYNTHESIS: Most instances of mitral valve prolapse are primary and inherited, with possible genetic heterogeneity. Mitral prolapse may be diagnosed by auscultation of midsystolic clicks and late-systolic murmurs that respond typically to maneuvers, or by billowing of mitral leaflets across the mitral anular plane in long-axis, two-dimensional echocardiographic views or by a late-systolic, posterior leaflet displacement of at least 2 mm in meticulously targeted M-mode recordings. Mitral valve prolapse is associated wit...