青少年僧帽瓣脫垂症候群之精神病理研究

Background and Purpose: Mitral valve prolapse (MVP) is a common valvular heart disease. The major symptoms of MVP include atypical chest pain, dyspnea, short of breath, dizziness and palpitation. The pathophysiology of MVP is not clear. Cardiac neurosis is also known as irritable heart disease or Da Costa syndrome, and has been described for hundred years. Methods: We randomly select 316 subjects from Taipei Langya junior high school. Those subjects with asthma, hypertension, congenital heart disease, or cardiac murmur greater than grade Ⅱ/Ⅵ were excluded from the study. After corrected with lie test, 27subjects were excluded and 289 subjects (146 males and 143 females) were enrolled in the study. Cardiac echo was used to determine the presence of MVP and to analyze the relationships among MVP and psychiatric symptom scales, and type A personality scales. Results: The psychiatric symptom scales of which includes somatization, obsession, sensitivity, depression, anxiety, hostility, phobia, global severity index, and position symptom distress index were not significantly different between subjects with MVP and those without MVP. Subjects were divided into two age groups: 14 years old or older and under 14. The somatization symptom in MVP is worse in the higher age group (P＜0.05) while the symptom of atypical chest pain, short of breath, and dizziness is less obvious in MVP (P＜0.05, P＜0.05, P＜0.005). In addition, type A personality was not significantly different between subjects with MVP and subjects without MVP. Conclusion: The study also showed that adolescent MVP did not have higher lie score, neurosity, and extroversion tendency. In conclusion, The MVP syndrome and cardiac neurosis in school adolescents may be different from each other.