Acute Crit Care.  2019 Nov;34(4):289-293. 10.4266/acc.2017.00570.

Two women presenting aborted sudden cardiac arrest as the first event of mitral valve disease

• Kim S
• Shim JM
• Park SM

• KMID: 2467310
• DOI: http://doi.org/10.4266/acc.2017.00570

Abstract

Mitral valve prolapse (MVP) is a relatively common valvular heart disease and is known to have a benign course. However, a certain subtype of MVP has a pathologic prognosis and can be accompanied by malignant cardiac arrhythmia causing sudden cardiac arrest, which can be characterized by bileaflet mitral valvular thickening and prolapse and frequent premature ventricular ectopic activity upon electrocardiography. Herein, we present two patients with bileaflet mitral prolapse who survived aborted sudden cardiac arrest. These cases show a precise MVP diagnosis that may prevent a devastating life event with the unique MVP subtype.

Keyword

arrhythmia; bileaflet; mitral valvular prolapse; sudden cardiac arrest

MeSH Terms

Arrhythmias, Cardiac
Death, Sudden, Cardiac*
Diagnosis
Electrocardiography
Female
Heart Valve Diseases
Humans
Mitral Valve Prolapse
Mitral Valve*
Prognosis
Prolapse

Figure

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  Figure 1. Electrocardiogram of case 1 presenting T wave inversion of inferior leads (A) and ventricular bigeminy (B).

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  Figure 2. Echocardiographic imaging of case 1. Two-dimensional image of parasternal long axis view (A) and apical two-chamber view (B) show bileaflet mitral valvular prolapse (red arrow) and backward displacement of the mitral annular ring (white arrow). Apical two-chamber view additively shows a hypertrophied papillary muscle (arrowhead). (C) Color Doppler image of the apical fourchamber view shows moderate mitral regurgitation (arrowhead).

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  Figure 3. Cardiac magnetic resonance imaging of case 1 shows a thinned inferobasal left ventricular wall (A, arrow) and inhomogenous signal intensity by late gadolinium enhancement suggesting damaged myocardium (B, arrow).

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