JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-1397
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Mitral annular disjunction as the cause of malignant ventricular arrhythmia in a young adult: a case report
Abstract
Mitral annular disjunction (MAD) is associated with ventricular arrhythmias and sudden cardiac death (VA/SCD). Risk prediction for VA/SCD in individuals with MAD includes clinical, ECG and imaging markers. Imaging assessment for MAD includes transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMRI) and there are certain features in each modality to aid both diagnosis and risk assessment. A 23-year-old female with no medical history presented to hospital following out of hospital cardiac arrest. Effective bystander CPR and successful cardioversion from ventricular fibrillation to sinus rhythm by paramedics achieved return of spontaneous circulation. Focused transthoracic echocardiography and cardiac magnetic resonance imaging identified MAD. Notably, there were no specific high risk clinical or imaging features. The patient recovered completely and was discharged with implantable defibrillator for secondary prevention. MAD is a rare cause of VA/SCD. Arrhythmias secondary to MAD are more likely with abnormalities on cardiac imaging, including late gadolinium enhancement, fibrosis of the mitral annulus or papillary muscles, mitral valve pathology and ventricular ectopic beats. In this case, none of the traditional risk factors for VA/SCD were present. Thus, MAD remains an important differential in all patients with an otherwise unexplained cardiac arrest, even if high risk features are not present.

Keywords : Imaging, mitral annular disjunction, malignant ventricular arrhythmias, malignant mitral valve

Download Article


1. Sabbag A, Essayagh B, Barrera JDR, et al. EHRA expert consensusstatement on arrhythmic mitral valve prolapse and mitral annulardisjunction complex in collaboration with the ESC Council on valvularheart disease and the European Association of Cardiovascular Imagingendorsed cby the Heart Rhythm Society, by the Asia Pacific HeartRhythm Society, and by the Latin American Heart Rhythm Society.Europace. 2022;24(12):1981-2003.
2. Wu S, Siegel RJ. Mitral annular disjunction: a case series and review ofthe literature. Front Cardiovasc Med. 2022;12(9):976066.
3. Dejgaard LA, Skjolsvik ET, Lie OH, et al. The mitral annulus disjunctionarrhythmic syndrome. J Am Coll Cardiol. 2018;72(14):1600-1609.
4. Drescher CS, Kelsey MD, Yankey GS, et al. Imaging considerations andclinical implications of mitral annular disjunction. Circ CardiovascImaging. 2022;15(9):014243.
5. Pocock WA, Bosman CK, Chesler E, Barlow JB, Edwards JE. Suddendeath in primary mitral valve prolapse. Am Heart J. 1984;107(2):378-382.
6. Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelinesfor the management of patients with ventricular arrhythmias and theprevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997-4126.
7. Essayagh B, Iacuzio L, Civaia F, Avierinos JF, Tribouilloy C, LevyF. Usefulness of 3-tesla cardiac magnetic resonance to detect mitralannular disjunction in patients with mitral valve prolapse. Am JCardiol. 2019;11(24):1725-1730.
8. Zugwitz D, Fung K, Aung N, et al. Mitral annular disjunction assessedusing CMR imaging: insights from the UK Biobank population study.JACC Cardiovasc Imaging. 2022;15(11): 1856-1866.
9. Putnam AJ, Kebed K, Mor-Avi V, et al. Prevalence of mitral annulardisjunction in patients with mitral valve prolapse and severeregurgitation. Int J Cardiovasc Imaging. 2020;36(7):1363-1370.
10. Pavon AG, Arangalage D, Pascale P, Hugelshofer S, Rutz T, PorrettaAP. Myocardial extracellular volume by T1 mapping: a new markerof arrhythmia in mitral valve prolapse. J Cardiovasc Magn Reson.2021;23(1):102.
Article available in :
Volume 2, Issue 3, 2024
Page : 61-63
https://doi.org/10.51271/JCCVS-0039
Article Information
Received : 25 Nis 2024
Accepted : 22 Tem 2024
Published : 30 Eyl 2024
Corresponding Author :

John Mooney: Central Coast Local Health District, NSW, Australia

[email protected]
Citation : Perkovic A, Chuah E, Mooney J. Mitral annular disjunction as the cause of malignant ventricular arrhythmia in a young adult: a case report. J Cardiol Cardiovasc Surg. 2024;2(3):61-63.

Read: 68
Cited: 0
Download : 52
_Footer