Mitral valve prolapse in patients with pure rheumatic mitral stenosis: An Angiographic Study

Of 122 adult patients suspected of having rheumatic mitral stenosis, 112 fu lfilled the hemodynamic and angiographic criteria for pure, isolated mitral stenosis. There were 88 females and 24 males with an age range of 16 to 60 years. The left ventriculograms (30 degrees right anterior oblique) were s ubjectively assessed for gross bulging of the mitral valve leaflets beyond the mitral fulcrum into the left atrium during a beat with maximal opacific ation. Seventeen percent of cases had typical evidence of mitral valve prol apse, which is much higher than the 3% to 5% rate reported for the general population. This phenomenon was independent of the patients' age, sex, hemo dynamic findings, and/or their underlying cardiac rhythm, thus implying the direct role of rheumatic mitral stenosis in the genesis of secondary mitra l valve prolapse.