Brain events associated with mitral valve prolapse.

The clinical and laboratory features of 24 patients with proven mitral valve prolapse (MVP) and brain dysfunction are reported. The age range of affected patients was between 20 and 63 years (average of 43) and 70 percent were women. MVP was documented prior to the brain illness in only 4 patients. The majority of patients experienced bland cerebral infarction. Disorders also included transient ischemic attacks, cerebellar infarctions, parencymatous and subarachnoid hemorrhage, seizures and retinal artery occlusion. Significant risk factors for stroke other than MVP were lacking in the patient group. Cerebral angiograms occasionally showed distal occlusions of small arteries suggesting embolic brain lesions. Our study suggests that MVP is a risk factor for stroke. We recommend echocardiography in patients with cerebral ischemia who lack clear, recognized risk factors for stroke. We believe the basis for this brain disorder to be emboli from damaged mitral valve leaflets.