Twenty three patients with fragile X syndrome underwent cardiovascular assessment. Echocardiography showed dilatation of the aortic root in 12 (52%) and mitral valve prolapse in five (22%), four of whom had an apical mid-systolic click on auscultation. Patients with fragile X syndrome have cardiac defects similar to those seen in other disorders of connective tissue such as Marfan's syndrome an...

In spite of numerous descriptions of the auscultatory and phonocardiographic findings in "adult" coarctation of the aorta (Reifenstein, Levine, and Gross, 1947; Wells, Rappaport, and Sprague, 1949; Brown et al., 1959; Cleland et al., 1956; Wood, 1956; Spencer, Johnston, and Meredith, 1958; Gasul, Arcilla, and Lev, 1966), no specific diagnostic auscultatory pattern has been outlined. The general...

Echocardiography has been accepted as the diagnostic modality of choice for mitral valve prolapse (MVP). The determine the effect of position on echocardiographic diagnosis of MVP, we examined 693 consecutive patients referred to the echocardiography laboratory because of suspected MVP. First, patients were examined using the usual standard M-Mode echocardiography( left parasternal third or fou...

Four clinical cases of subaortic hypertrophic muscular stenosis are discussed. All four, in addition to a loud systolic murmur, had a loud systolic click. However, the timing of the click and its relationship to the phase of the carotid pulse were different in each case varying from close to medium and to distant (or midsystolic). The comparison of the sound tracing with the carotid tracing dem...

Systolic Click Syndrome To the Editor: I have read with interest the article by Liedtke et al. (Circulation 47: 27, 1973) who have demonstrated a reduction in the extent of shortening of the proximal ventricular segment and the mitral valve ring, with an increase in the diameter of the ring in some of their patients. It is probable, however, that this angiographic appearance may have been due t...

Four patients had evidence that mitral valve prolapse was the etiology of isolated early systolic clicks that were "ejection" in timing, that is, within 80 msec of the first heart sound (S1). Phonocardiography demonstrated movement of the click closer to S, (three patients) with no change (three patients) or an increase in click amplitude (one patient) on inspiration. Earlier movement of systol...

Four patients had evidence that mitral valve prolapse was the etiology of isolated early systolic clicks that were "ejection" in timing, that is, within 80 msec of the first heart sound (S1). Phonocardiography demonstrated movement of the click closer to S, (three patients) with no change (three patients) or an increase in click amplitude (one patient) on inspiration. Earlier movement of systol...

A series of 20 cases is described of children with ventricular septal defects, in whom it was thought that a systolic ejection sound was heard. These were recorded using an accelerometer phonocardiographic technique which was particularly useful in childhood and infancy. Ten of these cases showed an early systolic click, the other IO showed a split first heart sound. Three of the cases with a s...