Disease | Mechanism of regurgitation |
Primary MVP | |
Nonclassic | Isolated prolapse of the mitral leaflet (commonly P2 scallop) Frequent chordal rupture Mild annular enlargement |
Forme fruste Barlow disease | Intermediate features |
Classic (Barlow disease) | Diffusely thickened, redundant mitral leaflets Chordal elongation/rupture Severe annular enlargement |
Secondary MVP | |
Associated with connective tissue disease* | Diffusely thickened, redundant mitral leaflets Chordal elongation/rupture Severe annular enlargement |
Associated with congenital heart disease¶ | Thickened, redundant mitral leaflets Chordal elongation/rupture possible |
Non-MVP flail mitral leaflet | |
Acute myocardial ischemia | Papillary muscle dysfunction with secondary prolapse/papillary muscle rupture |
Acute rheumatic fever | Chordal and leaflet destruction by acute inflammatory process |
Endocarditis | Chordal and leaflet destruction by infectious process; vegetations |
Other (trauma, severe mitral annular calcification, hypertrophic cardiomyopathy) | Ruptured chordae, no myxomatous changes of mitral valve leaflets |
* Associated with Marfan and Ehlers-Danlos syndromes, osteogenesis imperfecta, and pseudoxanthoma elasticum. Macroscopical and microscopical appearance similar to primary Barlow disease.
¶ Most common congenital disease associations are Ebstein's anomaly and atrial septal defect.Do you want to add Medilib to your home screen?