[A case of mitral valve prolapse associated with unusual posterior wall motion of the left ventricle: where has the myocardial theory gone?].

Abstract

A case with mitral valve prolapse was reported in which unusual movement of the posterior left ventricular wall was observed. The patient was a 45-year-old woman. Physical examination revealed loud multiple clicks at the apex. An electrocardiogram revealed T wave inversion in leads 2, 3 and aVF. Two-dimensional and M-mode echocardiography disclosed mid-systolic buckling of the mitral valve and late systolic 'dip' in the posterior wall of the left ventricle. An exaggerated excursion of the posterior wall during early diastole was also recorded by M-mode echocardiography. Pulsed and M-mode color Doppler echocardiography detected unusual anterograde flow near the mitral valve. This flow coincided well in timing with the early diastolic exaggerated excursion of the posterior wall. A discussion was made on the relation between abnormal left ventricular wall motion and mitral valve prolapse.