Mitral valve prolapse physical examination: Difference between revisions
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(Created page with "__NOTOC__ {{Mitral valve prolapse}} {{CMG}} ==Overview== == Auscultation == Upon auscultation a mid-systolic click is present, followed by a late systolic [[heart sounds|...") |
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{{Mitral valve prolapse}} | {{Mitral valve prolapse}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | ==Overview== | ||
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 [[marfan syndrome|marfans syndrome]]. | |||
==Physical Examination== | |||
===Appearance=== | |||
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 === | |||
====Auscultation==== | |||
=====Heart Sounds===== | |||
* A mid-to-late systolic click is present, followed by a late systolic [[heart sounds|murmur]] which is best heard at the cardiac apex. | |||
:* Click is early in [[systole]], if patient is standing, sitting or [[valsalva maneuver]].<ref name="pmid2667419">{{cite journal| author=Devereux RB, Kramer-Fox R, Kligfield P| title=Mitral valve prolapse: causes, clinical manifestations, and management. | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 4 | pages= 305-17 | pmid=2667419 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2667419 }} </ref> | |||
:* Click is late in systole, if patient is squatting or leg raising.<ref name="pmid2667419">{{cite journal| author=Devereux RB, Kramer-Fox R, Kligfield P| title=Mitral valve prolapse: causes, clinical manifestations, and management. | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 4 | pages= 305-17 | pmid=2667419 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2667419 }} </ref> | |||
* 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===== | ||
* 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]].<ref name="pmid2667419">{{cite journal| author=Devereux RB, Kramer-Fox R, Kligfield P| title=Mitral valve prolapse: causes, clinical manifestations, and management. | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 4 | pages= 305-17 | pmid=2667419 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2667419 }} </ref> | |||
* Murmur is shortened, if patient is squatting or leg raising.<ref name="pmid2667419">{{cite journal| author=Devereux RB, Kramer-Fox R, Kligfield P| title=Mitral valve prolapse: causes, clinical manifestations, and management. | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 4 | pages= 305-17 | pmid=2667419 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2667419 }} </ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 19:29, 23 October 2012
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Mitral valve prolapse Microchapters |
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Mitral valve prolapse physical examination On the Web |
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Risk calculators and risk factors for Mitral valve prolapse physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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
Appearance
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
Auscultation
Heart Sounds
- 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
- 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]