Mitral valve prolapse and cerebral ischemic events. A comparison between a neurology population with stroke and a cardiology population with mitral valve prolapse observed for five years.

Two populations of patients with mitral valve prolapse were analyzed to identify factors predisposing to the development of cerebral emboli. Of 760 patients followed for up to five years by our cardiologists with echocardiographically demonstrated mitral valve prolapse (MVP), only one, aged 82 years, has had a stroke. In contrast, of 43 patients admitted to our neurology service with a cerebral embolus and no evidence of carotid or other cardiac lesion and in whom echocardiography was performed, MVP was present in 9. No contributing etiologic mechanisms were uncovered to account for the disparity between the cardiology and neurology populations. However, with the apparent increased incidence of MVP in young patients with cerebral ischemia, both groups require longitudinal follow-up to understand better the factors that predispose a small percentage of patients with mitral valve prolapse to the development of cerebral ischemia.