In the process of evaluating an increasing number of people presenting with a midsystolic click and/or late systolic murmur, it became apparent that two distinct groups could be identified: Group 1 consists of patients who were referred for some other reason, are totally asymptomatic, have a mid-systolic click and/or a late systolic murmur on auscultation, and exhibit a typical ballooning posterior leaflet on echocardiography not due to any demonstrable organic heart disease. This group appears to be quite common. A second group of patients, presenting not only with the midsystolic click and/or late systolic murmur and a positive echocardiogram for ballooning posterior leaflet but also with overt symptomatology, are considered to have the ballooning posterior leaflet syndrome.
The inordinate emotional lability and many vague symptoms (chest pain, fatigue, palpitations) in patients with the complete syndrome was impressive. Indeed, symptoms of “neuropsychiatric origin” appeared to play a role in many of those patients described by Hancock and Jeresaty. In addition, the observation that emotional lability contributed to the sudden death of two patients with the ballooning posterior leaflet syndrome raised the question as to whether objective assessment of personality features might help to identify patients with the full syndrome particularly at risk for sudden death. A standardized personality test, the Minnesota Multiphasic Personality Inventory (MMPI), was, therefore, given to both groups of patients in an effort to more objectively assess the presence of gross psychopathology. Continue reading “The Ballooning Posterior Leaflet Syndrome: Minnesota Multiphasic Personality Inventory Profiles in Symptomatic and Asymptomatic Groups”