Mitral Leaflet Billowing and Prolapse: Its Prevalence Around the World

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Abstract
Primary mitral leaflet billowing, or so-called mitral valve prolapse, has become the most common valve anomaly in the United States and is also frequently found throughout the world. Its prevalence varies from less than 1% to 38%, differing not only between countries but also within the same country. The prevalence de pends on whether the study is clinical or echocardiographic, based on au topsy or surgical material, or of hos pital or non-care-seeking population. Other explanations for the varying prevalence are the age, sex and weight differences of the study popu lation, imprecise terminology, the care with which auscultation and/or echocardiography are carried out and interpreted, and some selection biases.