Case of Mitral Valve Prolapse – Associated Sudden Cardiac Death in Pregnancy

Patient: Female, 34-year-old Final Diagnosis: Ventricular arrhythmia Symptoms: Sudden cardiac death Medication:— Clinical Procedure: Echocardiography • electrocardiogram • magnetic resonance imaging Specialty: Cardiology OBJECTIVE: Unusual clinical course BACKGROUND: Mitral valve prolapse (MVP) is a frequent echocardiographic finding that can be accompanied by symptoms ranging from a benign course to occasionally catastrophic complications, such as heart failure, and rarely, sudden cardiac death. Female sex, younger age, physiological or psychological stress, electrical instability, and changes in the structure of the mitral apparatus all seem to be risk factors for fatal ventricular arrhythmias in patients with MVP. We report a case of MVP-related cardiac arrest in a pregnant woman, which is rarely reported. CASE REPORT: A 34-year-old woman who had collapsed at home from cardiac arrest was transported to the hospital. She had no history of cardiac diseases and was 8 weeks pregnant. Premature ventricular complexes and sinus tachycardia were observed on the 12-lead electrocardiogram as she arrived at the Emergency Department. The second cardiac arrest she experienced while in the hospital was observed to be from torsades de pointes. Further investigations revealed severe mitral valve regurgitation due to posterior leaflet prolapse and regional hypokinesis of the inferior wall and interventricular septum. CONCLUSIONS: Ventricular arrhythmia is a frequent finding of mitral valve regurgitation. However, it rarely results in serious consequences. Malignant arrhythmic mitral valve regurgitation can result in sudden cardiac death; therefore, physicians need to be aware of patients with MVP who exhibit characteristics of a potential high-risk profile in order to avoid tragic outcomes.