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February 21, 1986

The Management of Mitral Valve Prolapse

Author Affiliations

Wilmington, Del

JAMA. 1986;255(7):904. doi:10.1001/jama.1986.03370070058016

To the Editor.—  I found Dr Jeresaty's1 recent update on mitral valve prolapse in the Aug 9 issue of JAMA very useful. I would like to comment, however, on the use of antiplatelet therapy in these patients.As was mentioned, mitral valve prolapse probably plays a role in cerebral ischemia, at least in patients younger than 45 years of age.2I would also like to point to a study concerning platelet coagulant hyperactivity in patients with mitral valve prolapse.3 In this study, 100% of patients with mitral valve prolapse and thromboembolic complications showed platelet coagulant hyperactivity, as did 58% of patients with mitral valve prolapse but no history of thromboembolic or visual manifestations. This compared with only 6% of a control group without mitral valve prolapse showing platelet coagulant hyperactivity.Given this information, antiplatelet prophylaxis appears reasonable, especially in those patients who express concern, verbally or nonverbally, about