Out-of-hospital cardiac arrest in a mitral valve prolapse young male patient with acute mitral regurgitation due to cordal rupture. A case with a literature review 1. 3/2017-Ottobre 2. ISSN 2532-1285 3. /DOI: 10.23832/ITJEM.2017.017 Athanassios Antonopoulos Parent Category: Scientifici Hits: 53 Athanassios Antonopoulos (1) MD, PhD, FESC, Simona Postorivo (2) MD, Raffaella Francesconi (2) MD, Elisabetta Varani (1) MD 1) Department of Cardiology, Ospedale per gli Infermi, Faenza (RA), AUSL Romagna, Italy. 2) Emergency Medicine, Ospedale per gli Infermi, Faenza (RA), AUSL Romagna, Italy. Introduction Mitral valve prolapse (MVP) has been reported as a relatively common finding in the general population (1,2). Patients with relatively non-specific symptoms such as palpitations and atypical chest pain who are found to have MVP, continue to represent a major clinical conundrum for the practicing cardiologist (3). Cardiac arrhythmias and/or cardiac death is an underappreciated issue in MVP patients. When tested with Holter electrocardiogram (ECG) monitoring, MVP patients had a prevalence of ventricular arrhythmias as high as 34%, with premature ventricular contractions as the most common pattern (66% of the cases) (4). Anders et al presented a case series which suggest that even clinically benign cases of MVP in young adults might result in sudden unexpected death (5). In spite of that, cardiac arrest and arrhythmic sudden cardiac death (SCD) in patients with MVP based on the data of a community study are rare (6). In the present case we describe a patient with an out-of-hospital cardiac arrest due to ventricular fibrillation as the first manifestation of MVP. Case report A 33-year-old male had an out-of-hospital sudden cardiac arrest in a restaurant during lunch without foreign body obstruction. Friends who were together with him called the ambulance, which arrived 7 minutes later and started a first cardiac massage. Upon the arrival of the medical service, the initial observed cardiac rhythm was ventricular fibrillation (figure 1).