It is exactly this syndrome that may function a set off for a myocardial infarction.
Activation of the nervous system additionally causes pro-arrhythmic results, probably precipitating the arrhythmic occasion in our affected person.
Cardiac drugs has been clear that cardiac arrhythmias may very well be deadly if not handled, and particularly people who originate as a consequence of traction on the papillary muscle groups – very important buildings throughout the coronary heart positioned within the left and proper ventricle – in sufferers with arrhythmic mitral valve prolapse syndrome.
Precisely this syndrome can function a set off for a myocardial infarction, because it occurred within the case of a 63-year-old man, in line with a case revealed by the American College of Cardiology, which maintains that the affected person was discovered to have a mitral valve chord rupture.
Arrhythmic mitral valve prolapse syndrome is a not too long ago outlined situation, which incorporates frequent ventricular arrhythmias within the context of mitral valve prolapse – when the valve doesn’t shut correctly – and / or mitral annulus disjunction, which implies superior detachment. of the roots of the valve annulus of the ventricular myocardium to which it will usually be hooked up.
Arrhythmic mechanisms are presumed to incorporate elevated systolic stretch of the papillary muscle groups, the case maintains.
“However, our patient had cardiac arrest caused by a different mechanism than those implicated in sudden cardiac death from arrhythmic mitral valve prolapse syndrome. It can be speculated that the rupture of the cords induced the ventricular arrhythmia through the arrhythmogenic activation associated with this syndrome ”, the authors of this case keep.
The affected person had no historical past of earlier coronary heart assaults or sustained ventricular arrhythmias, and likewise didn’t meet the standards for implantation of an automated defibrillator. Therefore, it was included in a potential research of cardiac monitoring of sufferers with arrhythmic mitral valve prolapse syndrome, which yielded vital data relating to the affect of the syndrome on the event of cardiac arrest.
“We can speculate that mitral valve prolapse and tissue stretching by disjunction of the mitral annulus leads to progressive thinning of the chords, eventually followed by a rupture of the chordae tendineae that connect the mitral valve leaflets to the heart. It is unknown whether myocardial and papillary muscle fibrosis further contributes to cord rupture. Therefore, it is important to take into account that the risk of chord rupture as a possible complication of mitral valve prolapse and mitral annulus disjunction ”, highlights the case.
“The rupture of the cords produces a sudden worsening of mitral regurgitation, pulmonary edema and, ultimately, a life-threatening arrhythmia. Activation of the nervous system also causes pro-arrhythmic effects, potentially precipitating the arrhythmic event in our patient ”, they add.
The affected person underwent a profitable mitral valve restore and was implanted with a cardiac resynchronization system that causes the guts’s ventricles to contract on the similar time.
“More studies are needed to evaluate the risk of arrhythmias after valve surgery both in patients with arrhythmic mitral valve prolapse syndrome and in patients with mitral valve prolapse secondary to fibroelastic deficiency”, they conclude.
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