Cardiology Murmurs

Mitral Valve Prolapse

Mitral valve prolapse is a variant of MR in which some part of the mitral apparatus is too long, so that the valve does not function well at low volumes. At higher volumes, the valve leaflet may coapt normally. At low volumes, the leaflet may prolapse into the atrium during mid-to-late systole, causing a click or murmur or both.
On examination, patients with mitral valve prolapse may have a click, a mid-to-late systolic murmur, or both.

Patient 1

This is a middle-aged man with a known diagnosis of mitral valve prolapse who was admitted to the hospital for an unrelated issue. Note that the murmur occurs late in systole, which the novice can confuse for a diastolic murmur. There is no audible click in this case.

Mitral Valve Prolapse

Annotated