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Patients with mitral valve prolapse may have a mid-systolic click along with a murmur, referred to as apical late systolic murmur. [3] Early systolic clicks may also be present in some patients. [4] Aortic and pulmonary stenosis may cause an ejection click [5] immediately after S 1.
Mid-systolic ejection Dilation of aortic root or pulmonary artery Produces an ejection sound, with a short ejection systolic murmur and a relatively wide split S2. There is no hemodynamic abnormality. This is similar to pulmonary hypertension except the latter has hemodynamic instabilities. Mid-systolic ejection Increased semilunar blood flow
Upon auscultation of an individual with mitral valve prolapse, a mid-systolic click, followed by a late systolic murmur heard best at the apex, is common. The length of the murmur signifies the time period over which blood is leaking back into the left atrium, known as regurgitation.
Pulmonary valve stenosis is a crescendo-decrescendo systolic murmur. One can hear it best at the left upper sternal border. It has association with a systolic ejection click that increases with inspiration. This finding results from an increased venous return to the right side of the heart. Pulmonary stenosis sometimes radiates to the left ...
Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit.
Patients with a mitral valve prolapse are usually asymptomatic, but often have a classic heart murmur which includes a mid-systolic click, which is sometimes followed by a systolic murmur. The click is a result of the leaflet folding into the atrium and being suddenly stopped by the chordae tendineae.
If there is increased stroke volume of the left ventricle due to volume overload, an ejection systolic 'flow' murmur may also be present when auscultating the same aortic area. Unless there is concomitant aortic valve stenosis, the murmur should not start with an ejection click.
For example, a systolic ejection murmur, often accompanied by or without a systolic click, can be heard with a stethoscope. Patients may also feel tired easily (especially during physical activity), breathing difficulties (particularly during exertion), discomfort in the chest and lungs, and some individuals may also experience fainting episodes.