The specific aim of this study is to determine, using a non-concurrent prospective design, whether adults with idiopathic mitral valve prolapse (MVP) diagnosed by echocardiography are at increased risk for mortal and certain morbid events. The outcomes to be examined are: embolic events of the systemic arterial system; cardiovascular events; recurrent panic attacks; and migraine headaches. Adults who resided within the Baltimore SMSA, who underwent echocardiography since 1973, will be selected from Johns Hopkins Hospital, North Charles General Hospital, and Greater Baltimore Medical Center. The investigators propose to follow-up 900 patients meeting echocardiographic criteria for MVP, and 900 patients with not echocardiographic abnormalities. Two hundred patients with mitral stenosis will also be included in the study to evaluate bias in reporting outcomes. The echocardiographic diagnosis made at the time of the patients' examination will be validated. The patients' hospital charts will be reviewed, and the patients will be traced and interviewed by telephone. The patients' responses will be validated through hospitals and private physicians. Vital status will be ascertained using social security records search, and the National Death Index. Analysis will take into account the varying lengths of follow-up and will include person-time analysis, survival analysis techniques, and logistic analysis. Estimates of the risk of the outcomes will provide data which may be helpful for making appropriate decisions about medication and prophylaxis for adults with mitral valve prolapse. For example, mitral valve prolapse has an estimated prevalence of 10%-17% in young women of childbearing age. It is important to ascertain if these young women are at increased risk for embolic events. If they are, it might be appropriate to advise them against the use of oral contraceptives.
