Mitral valve prolapse is the most common cardiac valvular abnormality in industrialized nations, affecting approximately 4% of our population (7% of females). Although most adults who have mitral valve prolapse have a benign course, some develop severe mitral regurgitation, infective endocarditis, and sudden death. Despite long-standing efforts, to date only male gender, older age, and the presence of mitral regurgitation have consistently been strongly associated with these major complications. Using videotaped two-dimensional echocardiography, we are examining in vitro mitral valve morphology to identify risk factors to help clinicians predict which patients are at high risk of developing these complications.

Cardiovascular disease is the leading cause of death among men and women in this country. The diagnosis of coronary heart disease is more elusive in women. The standard electrocardiographic treadmill test has a high false positive rate among healthy menstruating women. We are looking at the menstrual cycle's effect, and more specifically, the influence of progesterone and estrogen levels on the electrocardiographic response to exercise.