Süleyman ERCAN, Mehmet Hayri ALICI, İbrahim SARI, Vedat DAVUTOĞLU, Muhammed OYLUMLU

Ani kardiyak ölümün nadir nedeni olarak mitral kapak prolapsusu vaka sunumu ve literatür derlemesi

Mitral kapak prolapsusu (MVP) çoğunlukla iyi seyirli, en yaygın kalp kapak hastalığı olarak kabul edilmektedir. Nadir olarak bu hastalıkta ventriküler ekstrasistol, mitral yetmezlik ve infektif endokardit gibi komplikasyonlar gelişebilir. Çok daha nadir olarak da MVP ani kardiyak ölüm sebebi olabilmektedir. Olgu sunumunda genç bir erkek hastada ani kardiyak ölüm ve başarılı resusitasyon uygulanan MVP olgusunu tartışmak istedik. Daha sonra implante edilebilir kardiyak defibrilatör (ICD) yerleştirilen ve tekrarlayan ventriküler taşikardi/fibrilasyon için toplam 17 defa ICD şoklaması izlenen hastada malign aritmi nedeni olarak MVP dışında hiç bir etyolojik neden bulunmadı. Literatürde de oldukça nadir bir ani kardiyak ölüm sebebi olarak bilinen MVPyi bu yönüyle tartışmayı ve ani ölüm risk faktörlerini gözden geçirmeyi planladık.

Mitral valve prolapsus as a rare cause of sudden cardiac death case presentation and review of literature

Mitral valve prolapsus (MVP) is common heart valve disease which is often accepted as benign. Rarely arrhythmias, mitral insufficiency and infective endocarditis can be seen in this disease. Much more rarely, MVP can lead to sudden cardiac death. We want to report and discuss that successful resuscitation of sudden cardiac death of a young male patient who had MVP. After then implantable cardiac defibrillator (ICD) was implanted to him with documented ICD defibrillation of 17 times for ventricular tachycardia/fibrillation. There was no reason for malignant arrhythmia as the cause of ICD discharge other then MVP. As a rare cause of sudden cardiac death, we aimed to discuss MVP and review sudden death risk factors in this entity.

PDF

___

1. Baedeker W. Mitral valve prolapse syndrome and arrhythmias. Herz 1988;13(5):318-25.
2. Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, et al. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med 1999;341(1):1-7.
3. Davies MJ, Moore BP, Braimbridge MV. The floppy mitral valve. Study of incidence, pathology, and complications in surgical, necropsy, and forensic material. Br Heart J 1978;40(5):468-81.
4. Kligfield P, Levy D, Devereux RB, Savage DD. Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 1987;113(5):1298-307.
5. Freed LA, Acierno JS Jr, Dai D, Leyne M, Marshall JE, Nesta F, et al. A locus for autosomal dominant mitral valve prolapse on chromosome 11p15.4. Am J Hum Genet 2003;72(6):1551-9.
6. Nishimura RA, McGoon MD, Shub C, Miller FA Jr, Ilstrup DM, Tajik AJ. Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients. N Engl J Med 1985;313(21):1305-9.
7. Marks AR, Choong CY, Sanfilippo AJ, Ferré M, Weyman AE. Identification of high-risk and low-risk subgroups of patients with mitral-valve prolapse. N Engl J Med 1989;320(16):1031-6.
8. Düren DR, Becker AE, Dunning AJ. Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. J Am Coll Cardiol 1988;11(1):42-7.
9. Penning R, Betz P, Werdan K. Incidence of sudden heart arrest in mitral valve prolapse syndrome. Versicherungsmedizin 1991;43(3):83-8.
10. Dollar AL, Roberts WC. Morphologic comparison of patients with mitral valve prolapse who died suddenly with patients who died from severe valvular dysfunction or other conditions. J Am Coll Cardiol 1991;17(4):921-31.
11. Akcay M, Yuce M, Pala S, Akcakoyun M, Ergelen M, Kargin R, et al. Anterior mitral valve length is associated with ventricular tachycardia in patients with classical mitral valve prolapse. Pacing Clin Electrophysiol 2010;33(10):1224-30.
12. Burke AP, Farb A, Tang A, Smialek J, Virmani R. Fibromuscular dysplasia of small coronary arteries and fibrosis in the basilar ventricular septum in mitral valve prolapse. Am Heart J 1997;134 (2 Pt 1):282-91.
13. Nishida N, Ikeda N, Esaki R, Kudo K, Tsuji A. Conduction system abnormalities in alcoholics with asymptomatic valvular disease who suffer sudden death. Leg Med (Tokyo). 2003;5(4):212-9.
14. Anders S, Said S, Schulz F, Püschel K. Mitral valve prolapse syndrome as cause of sudden death in young adults. Forensic Sci Int 2007;171(2-3):127-30.
15. Turker Y, Ozaydin M, Acar G, Ozgul M, Hoscan Y, Varol E, et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging 2010;26(2):139-45.