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Mitral Valve Prolapse in Women With Oral Contraceptive-Related Cerebrovascular InsufficiencyAssociated Persistent Hypercoagulable State
Marshall B. Elam, PhD, MD;
Mary J. Viar, MT;
Thomas E. Ratts, MD;
Carolyn M. Chesney, MD
Arch Intern Med. 1986;146(1):73-77.
Abstract
We examined a group of former oral contraceptive (OC) users, who had experienced cerebrovascular insufficiency, for the presence of hypercoagulable states. We found hypercoagulability in this group in the form of decreased plasma anti-thrombin III activity, increased platelet coagulant activity, and elevated plasma β-thromboglobulin level. Certain characteristics (cigarette smoking, vascular headache, hyperlipidemia, and mitral valve prolapse) were encountered with increased frequency among former OC users who had experienced cerebrovascular insufficiency. The association of mitral valve prolapse with OC-related cerebrovascular insufficiency was particularly striking. We propose that preexisting hypercoagulable states, such as may exist in a subset of individuals with mitral valve prolapse, will magnify the risk of OC-related cerebrovascular morbidity.
(Arch Intern Med 1986;146:73-77)
Author Affiliations
From the Divisions of Cardiovascular Disease (Drs Elam and Ratts) and Hematology (Dr Chesney), Department of Medicine, University of Tennessee Center for the Health Sciences, and the Department of Pathology, Baptist Memorial Hospital (Dr Chesney and Ms Viar), Memphis.
Footnotes
Accepted for publication March 19, 1985.
Read in part before the 56th scientific session of the American Heart Association, Anaheim, Calif, Nov 15, 1983.
Reprint requests to Department of Pharmacology, University of Tennessee Center for the Health Sciences, 874 Union Ave, Memphis, TN 38163 (Dr Elam).
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