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MVP

MVP. Mitral Valve Prolapse. Floppy-valve syndrome, Barlow’s syndrome Excessive connective tissue in the mitral leaflet  elongating and thickening the valve Displacement of the mitral valve into the LA during systole. Clinical Features of MVP. Females > males

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MVP

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  1. MVP

  2. Mitral Valve Prolapse • Floppy-valve syndrome, Barlow’s syndrome • Excessive connective tissue in the mitral leaflet  elongating and thickening the valve • Displacement of the mitral valve into the LA during systole

  3. Clinical Features of MVP • Females > males • More common among 14-30 years old • Body features that could be associated with MVP: • Asthenic body habitus • Low body weight or body mass index (BMI) • Straight-back syndrome • Scoliosis or kyphosis • Pectusexcavatum • Hypermobility of the joints • Arm span greater than height (which may be indicative of Marfan syndrome)

  4. Common PE Features Midsystolic Click • Classic auscultatory feature of MVP • Elongated leaflet balloons into the left atrium during systole leaflet collapses into the atrium, producing a click • Or produced by sudden tensing of slack, elongated chordae tendinae

  5. Midsystolic Click

  6. Mid- to Late Systolic Murmur • Midsystolic click may be followed by a high-pitched mid- to late systolic murmur • Crescendo-decrescendo, often heard best at the apex • Prolapse of the mitral valve causes some regurgitation of blood into the left atrium

  7. Mid- to Late Systolic Murmur • Occurrence of click and murmur vary according to position • In general, any maneuver that decreases the end-diastolic LV volume, increases the rate of ventricular contraction or decreases resistance to the LV ejection of blood causes MVP to occur earlier in systole (standing, valsalva maneuver)

  8. Due to dysautonomia • Anxiety • Panic attacks • Arrythmias • Exercise intolerance • Palpitations • Atypical chest pain • Fatigue • Orthostasis • Syncope or presyncope • Neuropsychiatric symptoms

  9. Due to progression of MR • Fatigue • Dyspnea • Exercise intolerance • Orthopnea • Paroxysmal nocturnal dyspnea (PND) • Progressive signs of congestive heart failure (CHF)

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