Mitral annular disjunction identified peripartum: A case highlighting key features of a recently classified syndrome

Abstract

Mitral annular disjunction (MAD) is the displacement of the mitral annulus hinge point from the left ventricular myocardium. MAD, which was first recognised in 1986, is of unconfirmed aetiology and was only classified as a syndrome in 2018. The reported prevalence of MAD is widely disputed. The more common and frequently comorbid mitral valve syndrome mitral valve prolapse is around 2%. As such, it is likely that the prevalence of MAD in general population is below 2%. The associated ventricular arrhythmias associated with MAD can potentially resolve in sudden cardiac death (SCD). This case report highlights some of the ‘textbook’ signs and symptoms of MAD, which were identified and aims to raise awareness of a novel yet critical syndrome.