Trends in mitral valve prolapse: a tertiary care center experience in Jeddah, Saudi Arabia

Ahmed Hussein Subki, Mahmoud Ghaleb Bakhaidar, Moaz Abdulrahman Bakhaider, Ali Abdulrahman Alkhowaiter, Rakan Salah Al-Harbi, Mohammed Ali Almalki, Khalid Abdullah Alzahrani, Maged Mazen Fakeeh, Siham Hussein Subki, Wesam Awad Alhejily Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Background: Mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in developed countries and it is associated with considerable morbidity and mortality. Aim of work: To study the clinical presentations, risk factors, and echocardiographic features of patients with MVP in Jeddah, Saudi Arabia. Materials and methods: A retrospective chart review study was conducted in King Abdulaziz teaching hospital in Jeddah, Saudi Arabia, from 2007 to 2017. All patients with MVP who were admitted at the hospital during this time period were recruited to this study, and demographic, clinical, and echocardiographic variables were analyzed using IBM SPSS. Results: Ninety-seven patients were recruited to this study, with a mean age of 43.82±16.16 years. Females constituted 67%. The body mass index (BMI) was 24.9±6.3 kg/m2. Hypertension, diabetes, and dyslipidemia occurred in 19.6%, 5.2%, and 5.2% of patients, respectively. A single patient had Marfan syndrome. Chest pain, palpitations, and dyspnea were the presenting symptoms in 23.7%, 11.3%, and 9.3% of patients, respectively, with elderly individuals presenting disproportionally (93.3%) with palpitations. Fifty-five percent of patients had an anterior leaflet prolapse. The presence of posterior leaflet prolapse and severe mitral regurgitation (MR) was significantly associated with left atrial and left ventricular dilatation (P<0.05 and P<0.001, respectively). Conclusion: MVP is more prevalent in women and middle-aged individuals with normal BMIs in this population. The most common clinical presentations were chest pain, palpitations, and dyspnea, which did not differ significantly with age or gender. The anterior leaflet was the most commonly prolapsed in the studied patients and presented with mild MR. Posterior leaflet MVP, while of low prevalence, was associated with severe MR and poor left ventricular function. Keywords: clinical presentation, echocardiography, mitral valve prolapse, prevalence, risk factor