in patients with asymptomatic mitral valve prolapse, a study has revealed that mortality and cardiovascular morbidity increased over time (1)
this study provides data to allow clearer risk statification of asymptomatic patients with newly diagnosed mitral valve prolapse
if a patient had either one of the two primary risk factors (an ejection fraction of < 50% or at least moderate mitral regurgitation) then s/he was considered at high risk - if compared with other groups over 10 years then patients at high risk had a greater cardiovascular morbidity and mortality, with a 45% mortality rate
intermediate risk was defined by the presence of >=2 secondary risk factors (slight mitral regurgitation, atrial fibrillation, flail leaflet, left atrium >= 40 mm, age >= 50 years) - these patients had a 10 year survival similar to that expected but a 40% cardiovascular morbidity
if a patient had zero or 1 secondary risk factor then s/he had a similar outcome to that of the general population
this study revealed a community population where 52% were low risk, 30% were intermediate risk, and 18% were high risk at diagnosis
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