A 25-year-old woman presents with chest pain and palpitations. Echocardiography shows billowing of the posterior mitral leaflet into the left atrium during systole. Histological examination of the excised valve would most likely show which change?

• A Aschoff bodies with Anitschkow cells
• B Fibrous thickening with commissural fusion
• C Vegetations composed of fibrin and bacteria
• D Myxomatous degeneration with mucopolysaccharide accumulation ✓

Explanation

Mitral valve prolapse is characterized by myxomatous degeneration, where excess glycosaminoglycans (mucopolysaccharides) accumulate in the valve leaflets, causing them to billow. This is the hallmark histological finding. Fibrous thickening with commissural fusion is seen in rheumatic heart disease. Vegetations with fibrin and bacteria indicate infective endocarditis. Aschoff bodies are pathognomonic for rheumatic fever. The billowing leaflet in a young woman with chest pain is classic for MVP.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.