Mitral valve prolapse: Difference between revisions
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*1 or more mitral valve leaflets bow into left atrium during systole | *1 or more mitral valve leaflets bow into left atrium during systole | ||
*Most common valve disease in industrial countries (2.4% of pop.) | *Most common valve disease in industrial countries (2.4% of pop.) | ||
*Myxomatous degeneration from connective tissue | *Myxomatous degeneration from [[connective tissue disorder]] | ||
==Symptoms== | ==Clinical Features== | ||
*Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP | ===Symptoms=== | ||
*Studies failed to demonstrate that [[chest pain]], [[anxiety]], or [[palpitations]] are associated with MVP | |||
*Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance | *Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance | ||
*If progresses to MR, CHF symptoms | *If progresses to MR, [[CHF]] symptoms | ||
==Physical exam== | ===Physical exam=== | ||
*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: | |||
**Pectus excavatum | |||
**Scoliosis | |||
**Low body weight | |||
**[[Marfan syndrome|Marfanoid]] habitus | |||
==Diagnosis== | ==Differential Diagnosis== | ||
{{Valvular emergencies DDX}} | |||
==Evaluation== | |||
===Workup=== | |||
*[[ECG]] can show nonspecific changes or arrhythmias | *[[ECG]] can show nonspecific changes or arrhythmias | ||
*[[CXR]] usually normal | *[[CXR]] usually normal | ||
*[[Echocardiography]] | |||
== | ===Diagnosis=== | ||
[[File:Mitralinsuff TEE.jpg|thumb|Transesophageal echocardiogram of mitral valve prolapse]] | |||
*Echocardiogram is gold standard | |||
== | ==Management== | ||
* | *Asymptomatic | ||
**None | **None | ||
*Symptoms of autonomic dysfunction | *Symptoms of autonomic dysfunction | ||
| Line 30: | Line 41: | ||
**Early surgical repair | **Early surgical repair | ||
*Neuro sequelae | *Neuro sequelae | ||
**Rule out [[a-fib]]/ left atrial thrombus, then [[aspirin]] | **Rule out [[a-fib]]/ left atrial thrombus, then [[aspirin]] daily | ||
*Click / Murmur | *Click / Murmur | ||
**Consider [[endocarditis]] | **Consider [[endocarditis]] | ||
| Line 40: | Line 51: | ||
*[[Mitral regurgitation]] | *[[Mitral regurgitation]] | ||
== | ==See Also== | ||
* | ==External Links== | ||
*[https://emedicine.medscape.com/article/759004-overview#showall Medscape - Mitral Valve Prolapse in Emergency Medicine] | |||
==References== | |||
<references/> | |||
[[Category: | [[Category:Cardiology]] | ||
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