Mitral valve prolapse
| Classification according to ICD-10 | |
|---|---|
| I34. | Mitral valve prolapse |
| ICD-10 online (WHO version 2019) | |
The term mitral valve prolapse (MKP) describes a mostly congenital (primary) malformation of the mitral valve apparatus of the human heart . The parts of the mitral valve bulge out into the left atrium during systole . It is found in 2.4% of all people.
to form
In the primary form, there is clumpiness and fraying of the valve edges, and the tendon threads are thinned. In about 40% of cases, there is also a prolapse of the tricuspid valve , in about 10% also of the aortic and pulmonary valve .
The secondary form can be in the context of a rheumatic or coronary heart disease or in the context of the rupture of the valve suspension ( tendon thread rupture ) z. B. occur in endocarditis . The morphological changes described above for the primary form are not found here.
clinic
The diagnosis is usually an incidental finding during auscultation (medium to late systolic click apical with subsequent high-frequency crescendo-decrescendo-late systolic ) or echocardiography (systolic protrusion of the cusps> 2 mm, thickening to> 5 mm). The patients are generally symptom-free, palpitations occur. A connection to the increased occurrence of shortness of breath , chest pain , syncope , panic attacks , as described in the past, cannot be statistically proven.
Only in 4% of cases is there a significant leak in the valve ( mitral valve insufficiency ). Signs of heart failure can develop here and relevant cardiac arrhythmias can occur. The likelihood of sudden cardiac death is higher than that of the normal population.
therapy
MKP usually does not require any therapy. Only severe mitral regurgitation should be treated surgically. In milder forms of insufficiency, normal (normotensive) blood pressure should be maintained.
The risk of endocarditis in the normal population is 5-7: 100,000 patient-years. With a prolapse without insufficiency it is 4.6: 100,000 and increases with a relevant insufficiency to 52: 100,000. In view of these numbers, endocarditis prophylaxis is not used today .
literature
- Mewis, Riessen, Spyridopoulos (Ed.): Cardiology compact - Everything for ward and specialist examination . 2nd Edition. Thieme, Stuttgart / New York 2006, ISBN 3-13-130742-0 , pp. 338-340 .
Individual evidence
- ↑ CK Naber et al .: Prophylaxis of infectious endocarditis - position paper of the German Society for Cardiology . In: cardiologist . tape 1 , no. 4 , November 21, 2007, pp. 243-250 , doi : 10.1007 / s12181-007-0037-x ( dgk.org [PDF]).
