Type B Aortic Dissection with Aneurysmal Dilation in a Patient with Myxoid Bi-Leaflet Mitral Valve Prolapse: A Case Report

Abstract

Background: Mitral valve prolapse is defined as the abnormal bulging of the mitral valve leaflets into the left atrium during ventricular systole. This relatively common condition is associated with several complications, notably mitral regurgitation. Case Presentation: We present the case of a 48-year-old male with no significant medical history who presented with exertional dyspnea and palpitations. Physical examination revealed a systolic murmur at the apex. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) confirmed the diagnosis of a bi-leaflet mitral valve prolapse with myxomatous degeneration, consistent with Barlow's disease, and significant mitral regurgitation (MR). Additionally, the imaging studies revealed dissection of the descending thoracic aorta, associated with aortic dilation. The patient underwent mitral valve replacement and medical treatment for aortic dissection. Conclusion: The coexistence of bileaflet mitral valve prolapse with myxomatous changes and a type B aortic dissection is rare. This case underscores the importance of considering such an association, even in the absence of classical symptoms such as thoracic or abdominal pain.