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Unusual Change in Murmurs in a Case of Mitral Valve Prolapse

Mitral valve prolapse (MVP) has changeable auscultatory features regarding the onset and amplitude with physiologic and pharmacologic maneuvers. We report a case of MVP in which not only the onset and amplitude of systolic murmurs but also the endpoint of systolic murmurs were dynamically altered ac...

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Autores principales: Honda, Sakiko, Yamano, Michiyo, Kawasaki, Tatsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509210/
https://www.ncbi.nlm.nih.gov/pubmed/36171823
http://dx.doi.org/10.7759/cureus.28411
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author Honda, Sakiko
Yamano, Michiyo
Kawasaki, Tatsuya
author_facet Honda, Sakiko
Yamano, Michiyo
Kawasaki, Tatsuya
author_sort Honda, Sakiko
collection PubMed
description Mitral valve prolapse (MVP) has changeable auscultatory features regarding the onset and amplitude with physiologic and pharmacologic maneuvers. We report a case of MVP in which not only the onset and amplitude of systolic murmurs but also the endpoint of systolic murmurs were dynamically altered according to preload. An asymptomatic 61-year-old man presented with a grade 3 crescendo murmur best heard at the apex, which started in the mid-systole without a click, and lasted up to the second sound. A diagnosis of moderate to severe mitral regurgitation due to MVP of P2 scallop was confirmed by echocardiography. At his regular follow-up visit, changes in cardiac auscultation were recognized although the patient was still asymptomatic. A grade 2, high-pitched crescendo murmur, which was softer than the previous findings, started immediately after the first sound and ended approximately 100 ms before the second sound on phonocardiography. On echocardiography, the severity of mitral regurgitation was abated in comparison with the previous findings, and mitral regurgitation abruptly ended in mid-systole but continued to the end of systole during increased preload due to an elevation of the legs. The present case highlights the importance of careful auscultation to estimate hemodynamic conditions in patients with MVP.
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spelling pubmed-95092102022-09-27 Unusual Change in Murmurs in a Case of Mitral Valve Prolapse Honda, Sakiko Yamano, Michiyo Kawasaki, Tatsuya Cureus Cardiology Mitral valve prolapse (MVP) has changeable auscultatory features regarding the onset and amplitude with physiologic and pharmacologic maneuvers. We report a case of MVP in which not only the onset and amplitude of systolic murmurs but also the endpoint of systolic murmurs were dynamically altered according to preload. An asymptomatic 61-year-old man presented with a grade 3 crescendo murmur best heard at the apex, which started in the mid-systole without a click, and lasted up to the second sound. A diagnosis of moderate to severe mitral regurgitation due to MVP of P2 scallop was confirmed by echocardiography. At his regular follow-up visit, changes in cardiac auscultation were recognized although the patient was still asymptomatic. A grade 2, high-pitched crescendo murmur, which was softer than the previous findings, started immediately after the first sound and ended approximately 100 ms before the second sound on phonocardiography. On echocardiography, the severity of mitral regurgitation was abated in comparison with the previous findings, and mitral regurgitation abruptly ended in mid-systole but continued to the end of systole during increased preload due to an elevation of the legs. The present case highlights the importance of careful auscultation to estimate hemodynamic conditions in patients with MVP. Cureus 2022-08-25 /pmc/articles/PMC9509210/ /pubmed/36171823 http://dx.doi.org/10.7759/cureus.28411 Text en Copyright © 2022, Honda et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Honda, Sakiko
Yamano, Michiyo
Kawasaki, Tatsuya
Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title_full Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title_fullStr Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title_full_unstemmed Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title_short Unusual Change in Murmurs in a Case of Mitral Valve Prolapse
title_sort unusual change in murmurs in a case of mitral valve prolapse
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509210/
https://www.ncbi.nlm.nih.gov/pubmed/36171823
http://dx.doi.org/10.7759/cureus.28411
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