Mitral valve prolapse physical examination: Difference between revisions
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{{Mitral valve prolapse}} | {{Mitral valve prolapse}} | ||
{{CMG}} | |||
==Overview== | ==Overview== | ||
MVP patients tend to have a low [[body mass index]] (BMI) and are typically leaner than individuals without [[MVP]]. They also have few skeletal abnormalities indicating any associated syndrome e.g. [[marfan syndrome]]. | |||
==Physical Examination== | ==Physical Examination== | ||
===Appearance=== | ===Appearance=== | ||
MVP | 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 === | === 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. | |||
=====Murmurs===== | |||
* Late systolic murmur | |||
* A holosystolic murmur may be present if severe prolapse occurs. | |||
* Best heard: | |||
:* Complete precordial area, if regurgitent 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}} | ||
Revision as of 18:54, 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
MVP patients tend to have a low body mass index (BMI) and are typically leaner than individuals without MVP. They also have few skeletal abnormalities indicating any associated syndrome e.g. marfan 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.
Murmurs
- Late systolic murmur
- A holosystolic murmur may be present if severe prolapse occurs.
- Best heard:
- Complete precordial area, if regurgitent 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]