Prevalence of mitral valve prolapse in younger patients with cerebral ischaemic attacks. A blinded controlled study.

The association between cerebral ischaemic attacks (CIA) and mitral valve prolapse (MVP) was investigated in a blinded study of 30 consecutive patients with cerebrovascular disease and 30 control patients matched by age, sex, and immediately apparent neurological signs. All patients were below the age of 40 years. Phonocardiography, motion-mode and two-dimensional echocardiography were performed at rest and during various manoeuvres. MVP demonstrated by all three diagnostic modalities was classified as definite and prolapse in at least one but not in all three tests were designated as ambiguous. Regarding the frequency of definite MVP, no statistically significant difference was demonstrated between patients with CIA (3%) and controls (0%). Ambiguous MVP was rather common in patients with cerebrovascular disease (13%) but equally frequent in control patients (20%). It is concluded that MVP does not appear particularly common in Northern Europe in younger patients with cerebral ischaemic events.