[Complications of mitral valve prolapse].

Mitral valve prolapse, usually a benign condition, is aggravated in 15% of the cases by one or the other of five different complications. Mitral regurgitation may develop progressively or abruptly following rupture of the chordae tendinae and requiring prompt surgical repair. Bacterial endocarditis has been observed in 2.9% of the cases, hence the need for preventive antibiotic therapy prior to dental treatments or surgical operations in patients with holosystolic or end-systolic mitral murmur. Among arrhythmias, only ventricular extrasystoles (which are frequent and most often occur in pairs or salvos or are polymorphous) tachycardia and ventricular fibrillation may be considered as true complications of mitral valve prolapse and should be treated initially with beta-blockers. Sudden death is the major complication encountered in 1.4 to 2.4% of the patients; particularly exposed are women around 40 years of age who previously experienced syncopes or episodes of faintness due to attacks of tachycardia or ventricular fibrillation. Ophthalmic or cerebral ischaemic accidents occur with an incidence of 3.5%; some 20 to 30% of subjects under 45 who suffer from these accidents present with mitral valve prolapse.