Mitral valve prolapse: Difference between revisions
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*Mid-systolic click | *Mid-systolic click | ||
*Late systolic [[murmur]], crescendo into S2 | *Late systolic [[murmur]], crescendo into S2 | ||
**Increasing preload decreases murmur while decreasing preload increases murmur | |||
*May have associated physical features: | *May have associated physical features: | ||
**Pectus excavatum | **Pectus excavatum | ||
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==See Also== | ==See Also== | ||
==External Links== | |||
*[https://emedicine.medscape.com/article/759004-overview#showall Medscape - Mitral Valve Prolapse in Emergency Medicine] | |||
==References== | ==References== | ||
Latest revision as of 02:37, 2 July 2021
Background
- 1 or more mitral valve leaflets bow into left atrium during systole
- Most common valve disease in industrial countries (2.4% of pop.)
- Myxomatous degeneration from connective tissue disorder
Clinical Features
Symptoms
- Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
- Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
- If progresses to MR, CHF symptoms
Physical exam
- Mid-systolic click
- Late systolic murmur, crescendo into S2
- Increasing preload decreases murmur while decreasing preload increases murmur
- May have associated physical features:
- Pectus excavatum
- Scoliosis
- Low body weight
- Marfanoid habitus
Differential Diagnosis
Valvular Emergencies
Evaluation
Workup
- ECG can show nonspecific changes or arrhythmias
- CXR usually normal
- Echocardiography
Diagnosis
- Echocardiogram is gold standard
Management
- Asymptomatic
- None
- Symptoms of autonomic dysfunction
- Signs of progression to MR
- Early surgical repair
- Neuro sequelae
- Click / Murmur
- Consider endocarditis