Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance

Background. Mitral valve prolapse (MVP) is a rare disorder linked to abrupt cardiac mortality and malignant ventricular arrhythmias. Beyond conventional prognostic indicators, risk stratification may have a promising function in MVP patients, as cardiac magnetic resonance imaging (CMR) can identify...

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Main Authors: Elen Sahara, Swandito Wicaksono, Celly Atmadikoesoemah
Format: Article
Language:English
Published: Indonesian Heart Association 2025-01-01
Series:Majalah Kardiologi Indonesia
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Online Access:https://ijconline.id/index.php/ijc/article/view/1681
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author Elen Sahara
Swandito Wicaksono
Celly Atmadikoesoemah
author_facet Elen Sahara
Swandito Wicaksono
Celly Atmadikoesoemah
author_sort Elen Sahara
collection DOAJ
description Background. Mitral valve prolapse (MVP) is a rare disorder linked to abrupt cardiac mortality and malignant ventricular arrhythmias. Beyond conventional prognostic indicators, risk stratification may have a promising function in MVP patients, as cardiac magnetic resonance imaging (CMR) can identify tissue alterations in these patients. Case Illustration. A 36-year-old female with palpitation, dyspnea on effort, and episode of near syncope had multifocal premature ventricular complex (PVC) with right bundle branch block patern. Bileaflet MVP with multifocal benign infrequent PVC from posteromedial papillary muscle was diagnosed in this patient based on echocardiography and holter monitoring. Mitral annular disjuction (MAD), mitral regurgitation (MR), tricuspid regurgitation (TR) were also noticed. CMR examination confirmed moderate MR ec AML-PML prolapse with MAD at PML (P1, P2, P3), moderate TR ec anterior tricuspid leaflet prolapse, myocardial inflammation and myocardial fibrosis. Conclusion. We present case report of a young woman diagnosed with PVC predominant from posteromedial papillary muscle and bileaflet with features of MAD, myocardial inflammation and fibrosis. The arrhythmogenesis in MVP involves the development of a substrate for arrhythmias combined with a trigger for arrhythmias. Future prospective research is needed to further delineate optimal methods for risk stratification and treatment
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publishDate 2025-01-01
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series Majalah Kardiologi Indonesia
spelling doaj-art-2df7aea9818941cd9470d8d89db10c192025-08-20T02:56:47ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-01-0145110.30701/ijc.1681Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic ResonanceElen Sahara0Swandito Wicaksono1Celly Atmadikoesoemah2Department of Cardiology and Vascular Medicine, Faculty Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty Medicine Universitas Indonesia, National Cardiovascular Center Harapan Kita Background. Mitral valve prolapse (MVP) is a rare disorder linked to abrupt cardiac mortality and malignant ventricular arrhythmias. Beyond conventional prognostic indicators, risk stratification may have a promising function in MVP patients, as cardiac magnetic resonance imaging (CMR) can identify tissue alterations in these patients. Case Illustration. A 36-year-old female with palpitation, dyspnea on effort, and episode of near syncope had multifocal premature ventricular complex (PVC) with right bundle branch block patern. Bileaflet MVP with multifocal benign infrequent PVC from posteromedial papillary muscle was diagnosed in this patient based on echocardiography and holter monitoring. Mitral annular disjuction (MAD), mitral regurgitation (MR), tricuspid regurgitation (TR) were also noticed. CMR examination confirmed moderate MR ec AML-PML prolapse with MAD at PML (P1, P2, P3), moderate TR ec anterior tricuspid leaflet prolapse, myocardial inflammation and myocardial fibrosis. Conclusion. We present case report of a young woman diagnosed with PVC predominant from posteromedial papillary muscle and bileaflet with features of MAD, myocardial inflammation and fibrosis. The arrhythmogenesis in MVP involves the development of a substrate for arrhythmias combined with a trigger for arrhythmias. Future prospective research is needed to further delineate optimal methods for risk stratification and treatment https://ijconline.id/index.php/ijc/article/view/1681arrhythmic mitral valve prolapsemitral annulus disjunctionendomyocardial fibrosis
spellingShingle Elen Sahara
Swandito Wicaksono
Celly Atmadikoesoemah
Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
Majalah Kardiologi Indonesia
arrhythmic mitral valve prolapse
mitral annulus disjunction
endomyocardial fibrosis
title Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
title_full Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
title_fullStr Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
title_full_unstemmed Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
title_short Arrhythmic Mitral Valve Prolapse with Features of Mitral Annular Disjunction and Myocardial Tissue Changes as Assessed with Cardiac Magnetic Resonance
title_sort arrhythmic mitral valve prolapse with features of mitral annular disjunction and myocardial tissue changes as assessed with cardiac magnetic resonance
topic arrhythmic mitral valve prolapse
mitral annulus disjunction
endomyocardial fibrosis
url https://ijconline.id/index.php/ijc/article/view/1681
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AT cellyatmadikoesoemah arrhythmicmitralvalveprolapsewithfeaturesofmitralannulardisjunctionandmyocardialtissuechangesasassessedwithcardiacmagneticresonance