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Psychiatric and medical co-morbidity in mitral valve prolapse

  • Efrain A Gonzalez (a1), Claudia Pimentel (a2), Ruby A Natale (a3), Benjamin A Toll (a3), Ariel Soffer (a4) and Leonard Gralnik (a5)...


Objective: Significant controversy continues to exist in the empirical literature regarding the diagnosis and treatment of mitral valve prolapse (MVP). In addition, there is also inconsistency in the correlation of anxiety disorders as co-existing with MVP, as well as cause and effect issues in terms of the role of the autonomic nervous system, MVP and panic attacks. Recent studies suggest that the co-morbidity of an anxiety disorder and clinical depression appears to increase the likelihood of MVP in predisposed patients. The objective of this review was to examine, clarify, and further define the medical and psychiatric aspects of MVP.

Methods: A literature review was conducted on empirical studies and reviews examining MVP.

Results: It was found that although MVP is highly correlated with psychiatric disorders, the lack of adequate control groups and clear criteria for a diagnosis of MVP in most empirical studies examining these associations make it difficult to determine the relationship between MVP and psychiatric disorders.

Conclusions: Suggestions for further research in the areas of depression and personality characteristics are offered. It is also suggested that the use of control groups from populations with cardiac disorders and a better definition of MVP will clarify many of the problems in empirical studies aiming to determine the relationship between MVP and psychiatric disorders.



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1.Dager, SR, Comess, KA, Saal, AK, Dunner, DL. Mitral valve prolapse in a psychiatric setting: Diagnostic assessment, research, and clinical implications. Integr Psychiatry 1986; 4: 211–20.
2.Singh, AN. Mitral valve prolapse syndrome. Int Med J 1996; 3: 101106.
3.Stavrakaki, C, Williams, EC, Boisjoli, A, Vlad, P, Chassé, H. Mitral valve prolapse and psychiatric complications: A case report. J Psychiatr Neurosci 1991; 16: 45–9.
4.Raj, A, Sheehan, DV. Mitral valve prolapse and panic disorder. Bull Menninger Clin 1990; 54: 199208.
5.Matuzas, W, Jafar, A, Uhlenhuth, RM, Glass, RM, Easton, C. Correlates of mitral valve prolapse among patients with panic disorder. Psychiatry Res 1989; 28: 161–70.
6.Dager, SR, Saal, AK, Comess, KA, Dunner, DL. Mitral valve prolapse and the anxiety disorders. Hosp Comm Psychiatry 1988; 39: 517–27.
7.Davies, NJ, Montague, TJ. Mitral valve prolapse: “The cardiac disease of the decade” revisited. Annals RCPSC 1989; 22: 307310.
8.Chaudhury, S, Augustine, M. Panic disorders accompanying mitral valve prolapse. Ind J Clin Psychol 1990; 17: 46–8.
9.Crowe, RR, Pauls, DL, Slymen, DJ, Noyes, R. A family study of anxiety neurosis: Morbidity risk in families of patients with and without mitral valve prolapse. Arch Gen Psychiatry 1980; 37: 77–9.
10.Gorman, JMet al.The mitral valve prolapse-panic disorder connection. Psychosom Med 1988; 50: 114–22.
11.Bowen, RC, Arcy, CD, Orchard, RC. The prevalence of anxiety disorders among patients with mitral valve prolapse syndrome and chest pain. Psychosomatics 1991; 32: 400–6.
12.Krakowski, AJ. Panic disorder associated with mitral valve prolapse: Psychosomatic implications. Psychother Psychosom 1987; 47: 211–8.
13.Kearney, CA, Drabman, RS, Joransen, JA, Lange, S, de Coronado, MDW. Mitral valve prolapse and symptoms of negative affectivity in adolescents. Children's Health Care 1996; 25: 133–41.
14.Margraff, J, Ehlers, A, Roth, WT. Mitral valve prolapse and panic disorder: A review of their relationship. Psychosom Med 1988; 50: 93113.
15.Chiaie, RDet al.Cardiovascular reactivity of mitral valve prolapse patients during experimental stress exposure: Evidence for a functional nature of cardiovascular symptoms. Acta Psych Scand 1996; 93: 434–41.
16.Zaubler, TS, Katon, W. Panic disorder and medical comorbidity: A review of the medical and psychiatric literature. Bull Menninger Clin 1996; 60(2, Suppl. A): A12A38.
17.Gorman, JM, Fyer, AF, Glicklich, J, King, D, Klein, DF. Effect of sodium lactate on patients with panic disorder and mitral valve prolapse. Am J Psychiatry 1981; 138: 247–9.
18.Hartman, N, Kramer, R, Brown, WT, Devereux, RB. Panic disorder in patients with mitral valve prolapse. Am J Psychiatry 1982; 139: 669670.
19.Kantor, JS, Zitrin, CM, Zeldis, SM. Mitral valve prolapse syndrome in agoraphobic patients. Am J Psychiatry 1980; 137: 467–9.
20.Hamada, T, Koshino, Y, Misawa, T, Isakaki, K, Gejyo, F. Mitral valve prolapse and autonomic function in panic disorder. Acta Psych Scand 1998; 97: 139–43.
21.Casat, C.D, Ross, BA, Scardina, R, Sarno, C, Smith, KE. Separation anxiety and mitral valve prolapse in a 12-year-old girl. J Am Acad Child Adol Psychiat 1987; 26: 444–6.
22.Crowe, RRet al.Exercise and anxiety neurosis: Comparison of patients with and without mitral valve prolapse. Arch Gen Psychiatry 1979; 36: 652653.
23.Weissman, NJ, Shear, Mk, Kramer-Fox, R, Devereux, RB. Contrasting patterns of autonomic dysfunction in patients with mitral valve prolapse and panic attacks. Am J Med 1987; 82: 880–8.
24.Yang, S,Tasai, TH, Hou, ZY, Chen, CY, Sim, CB. The effect of panic attack on mitral valve. Acta Psych Scand 1997; 96: 408–11.
25.Coplan, JD, Papp, LA, King, DL, Gorman, JM. Amelioration of mitral valve prolapse after treatment for panic disorder. Am J Psychiatry 1992; 149: 1587–8.
26.Lanning, W, Iverson, K. A study of the relationship between mitral valve prolapse and personality characteristics. J Am Coll Health 1988; 36: 223–5.
27.Powers, PS, Schocken, DD, Feld, J, Holloway, JD, Boyd, F. Cardiac function during weight restoration in anorexia nervosa. Int J Eating Dis 1991; 10: 521–30.
28.Johnson, G, Humphries, L, Shirley, P, Mazzoleni, A, Noonan, I. Mitral valve prolapse in patients with anorexia nervosa and bulimia. Arch Intern Med 1986; 146: 1525–9.
29.Devereux, MDet al.Relation between clinical features of the mitral valve prolapse syndrome and echocardiographically documented mitral valve prolapse. J Am Coll Cardiol 1986; 8: 763–72.
30.Meyers, DG, Starke, H, Pearson, PH, Wilken, MK. Mitral valve prolapse in anorexia nervosa. Ann Intern Med 1986; 105: 384–6.
31.Kaplan, AS, Goldbloom, DS, Woodside, DB, Swinson, RP, Kennedy, SH, Rakowski, H. Mitral valve prolapse in eating and panic disorder: A pilot study. Int J Eating Dis 1991; 10: 531–7.



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