mitral valve prolapse'" syndrome and associated ...

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MITRAL VALVE PROLAPSE'" SYNDROME AND ASSOCIATED THORACIC . . . ..... SKELETAL ABNORMALITIES . u K,i~bore Kumar".

KV Sanasranarn'"

SUMMARY Clinical characteristics of 60 (41 males, 19 females) patients with echocardioqraphicatty proven mitral valve prolapse were analysed, with .specia! interest in the associated thoracic skeletal abnormalities. There was a male preponderance (2.2:1) and.91.·7% of patients were symptomatic - atypical chest pain, palpitations, exertional dyspnoea and easy fatiguability being the major symptoms. Sixty seven percent had an asthenic body habitus, and 55°,6 had high-arched palate. Thoracic scoliosis (55%), straight back syndrome (50'%), flat chest (46.7%). and. pectus excavaturn (20%) were seen in association with the condition, with 81.7% having anyone or c0l11b.jr;i~,ij~.n,9.qbe:sefeatures. lateral chest radiography showed pancaking of heart shadow in 48.3%. Isolated.nan-ejection systolic click(s} was the major cardiac auscultatory finding (61.7%), while 60% showed 'pansystolfc "prolapse on echocardiography. Electrocardiographic ST-T-U changes in the inferior and/o';'''lat~rat;Ch'eSt'le'ads ~ere seen in 46.7%, while 16.7% had cardiac arrhythmias. None had infective endocarditis. hea/t''faildi~f~H' cerebral embolic events. The findings corroborate the view that thoracic skeletal anomalies ~~g~i.d~d as non-auscultatory features of this syndrome ..

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Mitral valve prolapse syndrome' fMVP'S) 'is::'defined'

-as a condition characterised by systolic protrusion of one or both the mitral valve leafletsinto the left atrium. Subsequent to population studies in the Western world, this entity has come to be accepted as the commonest cardiac valvular abnormality - noted in as much as 5-10% of the general population, with a relatively higher frequency in temales.' Indian studies on the subject - especially from'Sb'uth India - are very few. The present study analysed the clinical character'Posrqraouate sruceru (at present. consonant physicran. Fatima Hospnat. Wynad) ... ASSOCiate Professor. Depanmenl of Cardiology. Medica: COllege. Caticut 673 008. Kerala. ' Received: 2.1.1990 Accepteo 6.5.1990

536

istics of a group of MVPS patients attending the Government Medical College Hospital at Calicut, which caters to the whole of North Kerala. MATERIAL AND METHODS Sixty consecutive patients (41 men, 19 women) seen at our Cardiology Clinic Over 17 months, from November 1984 to April 1986, with clinical evidence of MVPS, as evidenced by the presence of non-ejection systolic clic~(s} with or without a murmur, were included in the study. The diagnosis was confirmed by 20 echocardiography. Clinical evaluation included a detailed clinical history, physical examination with emphasis on the postural auscultatory variation of the click and murmur, and . evidence of arrhythmias, infective endocarditis, and JAPI 1991, VOL 39, No. i