Mitral valve prolapse: Difference between revisions
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*Myxomatous degeneration from [[connective tissue disorder]] | *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: | *May have associated physical features: | ||
**Pectus excavatum | **Pectus excavatum | ||
**Scoliosis | **Scoliosis | ||
**Low body weight | **Low body weight | ||
**Marfanoid habitus | **[[Marfan syndrome|Marfanoid]] habitus | ||
==Differential Diagnosis== | |||
{{Valvular emergencies DDX}} | |||
==Evaluation== | ==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== | ==Management== | ||
* | *Asymptomatic | ||
**None | **None | ||
*Symptoms of autonomic dysfunction | *Symptoms of autonomic dysfunction | ||
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**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]] | ||
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*[[Arrhythmia]] | *[[Arrhythmia]] | ||
*[[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== | ||
<references/> | <references/> | ||
[[Category:Cardiology]] | [[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