Billowing mitral leaflet syndrome may be associated with acute myocardial infarction in the presence of normal coronary arteries, potentially due to coronary spasm.
Hypothesis-generating for coronary spasm in billowing mitral leaflet syndrome with MI and normal coronaries; larger studies needed to confirm association.
The findings in four young patients with the billowing mitral leaflet syndrome who presented with evidence of acute myocardial infarction are reported. Because technically adequate coronary arteriograms demonstrated patent vessels and the electrocardiograms initially showed pronounced elevation of the ST segments as occurs in Prinzmetal's angina, it is postulated that spasm of normal coronary arteries was the operative factor. Scrutiny of those cases of clinically apparent ischemic heart disease with normal coronary angiograms is suggested to establish whether there is in fact a causal relationship with the billowing mitral leaflet syndrome.
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Chesler et al. (1976) studied this question.
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