Some patients with mitral valve prolapse (MVP) may develop one or more arrhythmias and suffer sudden cardiac arrest.
ECGs may show:
(1) sinoatrial block
(2) right bundle branch block
(3) prolonged QT interval
(4) complex ventricular ectopy
(5) inferolateral repolarization changes
(6) premature ventricular contractions (PVCs)
(7) atrial premature contractions (APCs)
(8) supraventricular or ventricular tachyarrhythmias
(9) ventricular fibrillation
Patients with arrhythmias may be young and show little or no mitral valve regurgitation.
Patients may have a history of:
(1) recurrent syncope
(2) palpitations
Ambulatory ECG (Holter monitor) can be helpful in detecting arrhythmias.
Fibrosis of the papillary muscles and inferobasal left venticular wall correlates with ventricular arrhythmias (Basso et al).
Management may include beta blockade and placement of an implantable cardioverter defibrillator.
