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MITRAL VALVE PROLAPSE. MM, 23 y/o, F. Cc: PALPITATION. PHYSICAL EXAMINATION. Conscious, coherent, ambulatory BP: 110/70 CR 80/min regular RR 16/min BMI 19 Symmetrical chest expansion, narrow A-P diameter of the chest, no retractions, clear breath sounds
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MM, 23 y/o, F Cc: PALPITATION
PHYSICAL EXAMINATION • Conscious, coherent, ambulatory • BP: 110/70 CR 80/min regular RR 16/min • BMI 19 • Symmetrical chest expansion, narrow A-P diameter of the chest, no retractions, clear breath sounds • Adynamicprecordium, AB at 5th LICS MCL, no murmurs, (+) midsystolic click followed by 2/6 midsystoliccresecendo murmur noted at the apex
REVIEW OF SYSTEMS • (-) dizziness • (-) loss of consciousness • (-) cough or colds • (-) PND or Orthopnea
LABORATORY AND ANCILLARY TEST • 2D Echo-Doppler: MVP, anterior mitral valve leaflet with moderate MR, slightly dilated LA with no evidence of thrombus • 123L ECG: sinus rhythm, occasional premature atrial complexes • CXR: Normal
Question # 1 What are the common Pe findings of mvp?
Physical examination • Body weight is often low ; asthenic • Blood pressure is usually normal or low • Orthostatic hypotension • Resting bradycardia • Thoracic skeletal abnormalities suggesting MVP: • Scoliosis, pectus excavatum, straightened thoracic spine, and narrowed AP dm of the chest Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders
Auscultation: • Nonejection systolic click at least 0.14 sec after S1 • Multiple mid and late systolic clicks along the L lower sternal border • Mid to late crescendo systolic murmur that continues to A2 Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders
Dynamic Auscultation: Zippes, D., et al. (2005) Braunwald’s Heart Disease: A textbook of Cardiovascular Medicine, 7th ed. USA: Elsevier Saunders
Dynamic Auscultation: Response of the Murmur of MVP to Interventions Fuster, V.,et al. (2008) . Hurst’s The Heart, 12the ed. China: McGrawHill Co.
NING =) Yung mga hidden slides, pareholangnungmganakashow. Masmagandakaseyungginawanigelyn. Hehehe. Yung ibalangkase s a slides n a gnawako, may konting explanation kayasinamako pa din. hehe