Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature
Mitral annulus disjunction (MAD) is defined as a systolic displacement between the ventricular myocardium and the posterior mitral annulus supporting the posterior mitral leaflet. This structural abnormality is associated with the loss of mechanical annular function manifested as an abnormal systoli...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1171226/full |
| _version_ | 1797776110635712512 |
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| author | Fay Apostolou Marios Ioannides Andreas Mitsis Constantina Koutsofti Constantinos Deltas Constantinos Deltas Panayiotis Avraamides |
| author_facet | Fay Apostolou Marios Ioannides Andreas Mitsis Constantina Koutsofti Constantinos Deltas Constantinos Deltas Panayiotis Avraamides |
| author_sort | Fay Apostolou |
| collection | DOAJ |
| description | Mitral annulus disjunction (MAD) is defined as a systolic displacement between the ventricular myocardium and the posterior mitral annulus supporting the posterior mitral leaflet. This structural abnormality is associated with the loss of mechanical annular function manifested as an abnormal systolic excursion of the leaflet hinge point into the left atrium but with maintained electrical function, separating the left atrium and ventricle electrophysiologically. The mitro-aortic fibrous continuity limits MAD anteriorly, between the aortic cusps and the anterior leaflet of the mitral valve. Consequently, MAD has been observed only at the insertion of the posterior leaflet. It can extend preferentially at the central posterior scallop. The first diagnostic modality aiding the diagnosis is transthoracic echocardiography (TTE), although in some cases adjunctive cardiac imaging modality might be suggested. MAD carries a strong association with malignant ventricular arrhythmogenesis and a profound predisposition for sudden cardiac death (SCD). In this context, a thorough investigation of this morphological and functional abnormality is vital in estimating the risk assessment and stratification for optimal management and elimination of the risk of the patient for SCD. Based on the current scientific data and literature, we will discuss the diagnosis, clinical implications, risk stratification, and therapeutic management of MAD. |
| first_indexed | 2024-03-12T22:45:16Z |
| format | Article |
| id | doaj.art-7ea6816a92624c0dba2e970bb324e122 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T22:45:16Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7ea6816a92624c0dba2e970bb324e1222023-07-21T06:36:52ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-07-011010.3389/fcvm.2023.11712261171226Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literatureFay Apostolou0Marios Ioannides1Andreas Mitsis2Constantina Koutsofti3Constantinos Deltas4Constantinos Deltas5Panayiotis Avraamides6Department of Cardiology, Nicosia General Hospital,Strovolos, CyprusDepartment of Cardiology, Nicosia General Hospital,Strovolos, CyprusDepartment of Cardiology, Nicosia General Hospital,Strovolos, CyprusBiobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus,Nicosia, CyprusBiobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus,Nicosia, CyprusSchool of Medicine, University of Cyprus, Nicosia, CyprusDepartment of Cardiology, Nicosia General Hospital,Strovolos, CyprusMitral annulus disjunction (MAD) is defined as a systolic displacement between the ventricular myocardium and the posterior mitral annulus supporting the posterior mitral leaflet. This structural abnormality is associated with the loss of mechanical annular function manifested as an abnormal systolic excursion of the leaflet hinge point into the left atrium but with maintained electrical function, separating the left atrium and ventricle electrophysiologically. The mitro-aortic fibrous continuity limits MAD anteriorly, between the aortic cusps and the anterior leaflet of the mitral valve. Consequently, MAD has been observed only at the insertion of the posterior leaflet. It can extend preferentially at the central posterior scallop. The first diagnostic modality aiding the diagnosis is transthoracic echocardiography (TTE), although in some cases adjunctive cardiac imaging modality might be suggested. MAD carries a strong association with malignant ventricular arrhythmogenesis and a profound predisposition for sudden cardiac death (SCD). In this context, a thorough investigation of this morphological and functional abnormality is vital in estimating the risk assessment and stratification for optimal management and elimination of the risk of the patient for SCD. Based on the current scientific data and literature, we will discuss the diagnosis, clinical implications, risk stratification, and therapeutic management of MAD.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1171226/fullmitral valve prolapsemitral annulus disjunctionsudden cardiac deathventricular arrhythmiatransthoracic echocardiography |
| spellingShingle | Fay Apostolou Marios Ioannides Andreas Mitsis Constantina Koutsofti Constantinos Deltas Constantinos Deltas Panayiotis Avraamides Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature Frontiers in Cardiovascular Medicine mitral valve prolapse mitral annulus disjunction sudden cardiac death ventricular arrhythmia transthoracic echocardiography |
| title | Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature |
| title_full | Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature |
| title_fullStr | Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature |
| title_full_unstemmed | Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature |
| title_short | Case report: Aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction—a case series and review of the literature |
| title_sort | case report aborted sudden cardiac death as a first presentation of severe mitral annulus disjunction a case series and review of the literature |
| topic | mitral valve prolapse mitral annulus disjunction sudden cardiac death ventricular arrhythmia transthoracic echocardiography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1171226/full |
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