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  1. Madalina Garbi1,
  2. Francis Wells2,
  3. Jonathan Weirmccall3,
  4. Robert H Anderson4
  1. 1 Cardiology, Royal Papworth Hospital, Cambridge, UK
  2. 2 Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK
  3. 3 Radiology, Royal Papworth Hospital, Cambridge, UK
  4. 4 Biosciences Institute, Newcastle University, Newcastle, UK
  1. Correspondence to Dr Madalina Garbi, Cardiology, Royal Papworth Hospital, Cambridge CB2 0AY, UK; madalina.garbi{at}

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To the Editor

We read with interest the recent publication1 and the associated editorial2 on multimodality imaging of mitral annular disjunction (MAD) in mitral valve prolapse (MVP). MAD is an almost ubiquitous anatomical variant, measuring from 1 to 1.5 mm in histological sections of mitral valves with or without prolapse. MVP can be associated with malignant arrhythmia, leading to out-of-hospital cardiac arrest or sudden cardiac death. Slightly longer, MAD was found in pathology specimens from sudden cardiac death victims,3 and this finding triggered …

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  • Contributors All authors contributed to the submitted letter to editor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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