JACC. Case reports · 2026
Arrhythmogenic Mitral Valve Prolapse: Looking Beyond Mitral Regurgitation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Ribeyrolles Sophie, Zannis Konstantinos, Berrebi Alain, Jorrot Pierre, Ferrag Warda, Sfeir Maroun, Bourghoud Rayene, Diakov Christelle, Caussin Christophe
Аннотация
BACKGROUND: Mitral valve prolapse (MVP) is usually evaluated through the severity of mitral regurgitation (MR), yet some patients may exhibit an arrhythmogenic phenotype associated with life-threatening ventricular arrhythmias.
CASE SUMMARY: A 70-year-old asymptomatic woman with Barlow disease was referred for MR reassessment. Echocardiography showed bileaflet prolapse, moderate to severe MR, mitral annular disjunction, and left-sided chamber remodeling. Ambulatory electrocardiographic monitoring revealed frequent polymorphic premature ventricular complexes. Before work-up completion, she experienced an out-of-hospital ventricular fibrillation with cardiac arrest. Cardiac magnetic resonance demonstrated inferolateral myocardial fibrosis. She underwent implantable cardioverter-defibrillator placement, followed by mitral valve repair and surgical ablation.
DISCUSSION: This case highlights the need to identify arrhythmogenic MVP early, using an integrated clinical, electrocardiographic, echocardiographic, and cardiac magnetic resonance approaches for individualized risk stratification.
TAKE-HOME MESSAGE: In patients with MVP, arrhythmic risk stratification should go beyond MR severity, integrating red flags with clinical assessment, serial multimodality imaging, and a multidisciplinary team involving imaging, electrophysiology, and surgical expertise.
CASE SUMMARY: A 70-year-old asymptomatic woman with Barlow disease was referred for MR reassessment. Echocardiography showed bileaflet prolapse, moderate to severe MR, mitral annular disjunction, and left-sided chamber remodeling. Ambulatory electrocardiographic monitoring revealed frequent polymorphic premature ventricular complexes. Before work-up completion, she experienced an out-of-hospital ventricular fibrillation with cardiac arrest. Cardiac magnetic resonance demonstrated inferolateral myocardial fibrosis. She underwent implantable cardioverter-defibrillator placement, followed by mitral valve repair and surgical ablation.
DISCUSSION: This case highlights the need to identify arrhythmogenic MVP early, using an integrated clinical, electrocardiographic, echocardiographic, and cardiac magnetic resonance approaches for individualized risk stratification.
TAKE-HOME MESSAGE: In patients with MVP, arrhythmic risk stratification should go beyond MR severity, integrating red flags with clinical assessment, serial multimodality imaging, and a multidisciplinary team involving imaging, electrophysiology, and surgical expertise.