Reverse Δ-wave as a possible sign in electrocardiography to diagnose mitral valve prolapse

BACKGROUND: Mitral valve prolapse (MVP) is defined as superior displacement of the mitral valve leaflets more than 2 mm into the left atrium during systole. Easier and cheaper assessment of this common disease is a priority in cardiac health care facilities. PRESENTATION OF THE HYPOTHESIS: In this study I addressed electrocardiographic presentation in 300 patients with MVP compared with 100 healthy individuals. I faced a novel finding in electrocardiogram (ECG) examination of these patients. It was a notch (reverse Δ-wave) in descending arm of QRS observed in 79% (237/300) of patients, consisting of 58% (174/300) in inferior leads and 21% (63/300) in I and aVL leads. The notch was identified only in 6 men in control group. TESTING THE HYPOTHESIS: Considering the relatively higher prevalence of disease, a population-based diagnostic clinical trial study is appropriate to test the hypothesis. IMPLICATIONS OF THE HYPOTHESIS: The hypothesis on diagnostic value of reverse Δ-wave in MVP may help in decreasing the rate of unnessessary echocardiography in some patients.