Mitral valve prolapse Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Chest X ray

MRI

Echocardiography

Left ventriculography

Treatment

Medical Therapy

Surgery

Tertiary Prevention

Mitral valve prolapse physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Mitral valve prolapse physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Mitral valve prolapse physical examination

CDC on Mitral valve prolapse physical examination

Mitral valve prolapse physical examination in the news

Blogs on Mitral valve prolapse physical examination

Directions to Hospitals Treating Mitral valve prolapse

Risk calculators and risk factors for Mitral valve prolapse physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview[edit | edit source]

Classic finding on cardiac exam is a late holosystolic murmur with a mid-systolic click. MVP patients tend to have a low body mass index (BMI) and are typically leaner than individuals without MVP. They may also have skeletal abnormalities possibly indicating the presence of a syndrome such as marfans syndrome.

## Physical Examination[edit | edit source]

### Appearance[edit | edit source]

Skeletal deformities which may be found in patients with MVP are:

* Narrow anteroposterior chest diameter
* Scoliosis or kyphosis
* Pectus excavatum
* Hypermobility of the joints
* Arm span greater than height

### Heart[edit | edit source]

#### Auscultation[edit | edit source]

##### Heart Sounds[edit | edit source]

* A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex.

* Click is early in systole, if patient is standing, sitting or valsalva maneuver.[1]
* Click is late in systole, if patient is squatting or leg raising.[1]

* First heart sound, S1 is normal as initial closure of mitral valve cusps is unimpeded.
* In presence of pulmonary hypertension, pulmonic component of second heart sound (P2) is loud.

{{#ev:youtube|PsmGx2XMxF8}}

##### Murmurs[edit | edit source]

* Late systolic murmur is present early in the course of disease.
* A holosystolic murmur may be present if severe prolapse occurs.
* Best heard:

* Complete precordial area, if regurgitant blood is directed anteriorly.
* Back and left axilla, if regurgitant blood is directed posteriorly.

* Murmur is prolonged, if patient is standing, sitting or valsalva maneuver.[1]
* Murmur is shortened, if patient is squatting or leg raising.[1]

## References[edit | edit source]

1. ↑ 1.0 1.1 1.2 1.3 Devereux RB, Kramer-Fox R, Kligfield P (1989). "Mitral valve prolapse: causes, clinical manifestations, and management". Ann Intern Med. 111 (4): 305–17. PMID 2667419.CS1 maint: Multiple names: authors list (link)

Template:WH Template:WS