Mitral valve prolapse complicated by acute cerebral embolism, arrhythmias and painless myocardial infarction. A case presentation and overview
Przybojewski, J.Z.; Tredoux, J.G.; van der Walt, J.J.; Tiedt, F.A.
South African Medical Journal 65(10): 390-396
1984
ISSN/ISBN: 0256-9574 PMID: 6701695 Document Number: 227364
A case of 'primary' mitral valve prolapse is documented. The patient was admitted with right-sided hemiplegia of sudden onset, probably caused by a cerebral embolus from the mitral valve. He also had a painless transmural inferior myocardial infarction (MI) of indeterminate age which was diagnosed electrocardiographically and on left ventricular cine angiography. Since selective coronary arteriography delineated the absence of fixed obstructive atherosclerotic disease, and since coronary vasospasm could not be provoked with the ergonovine (ergometrine) maleate test, it is further postulated that a coronary embolus from the abnormal mitral valve apparatus was responsible for the painless MI. A percutaneous right ventricular endomyocardial biopsy specimen displayed findings not indicative of a 'cardiomyopathy'.