The onset of mitral valve prolapse and its close correlate, the time of systolic click, vary considerably with different physiologic and pharmacologic interventions. In order to explain the mechanism responsible for these alterations, the effects of tilt and amyl nitrite inhalation on left ventricular dynamics and the time of the systolic click were studied by analyzing echocardiograms and simu...

A contraction abnormality of the left ventricle has previously been described in patients with systolic click-late systolic murmur syndrome. To determine if the contraction abnormality is present in the preprolapse period, LV dimensions and the instantaneous velocity of circumferential fiber shortening (VCF) were studied in 18 patients with the mitral valve prolapse and 16 normal subjects using...

Fifteen patients with the clinical and phonocardiographic finding of a nonejection click initiating a late systolic murmur had apexcardiograms (ACG) performed. In every case, the inward motion of the apex normally inscribed between aortic valve opening and closure was interrupted by either a notch or a second systolic wave, the onset of which occurred at the time of the click. This ACG finding ...

The systolic murmurs heard in healthy subjects used to be called " functional " murmurs. White et al. (1942) recommended the term " physiologic." Evans (1947) called these murmurs " innocent." Others have called them " incidental,' "' accidental,'' or "' murmurs of unknown origin." The decision that a systolic murmur is innocent usually depends not only on the character of the murmur itself, bu...

494 COMMUNICATIONS TO THE EDITOR CHEST, 76: 4, OCTOBER, 1979 6 Kleid JJ, Aryan SB, Martin C: Systolictime intervals in the syndrome of midsystolic click and late systolic murmur. Chest 71:85-69, 1977 7 Lewis EP, Rittgers SE, Forrester WF, et al: A critical review of the systolic time intervals. Circulation 56:146157, 1977 8 Wanderman KL, Goldberg MJ, Stack RS, et al: Left ventricular performanc...

In 1966 Barlow and Bosman(1) described a constellation of clinical fi ndings consisting of non-ejection systolic clicks and a late systolic murmur, T-wave abnormalities, and systolic aneurysmal billowing of the posterior mitral leafl et into the left atrium. Since then, in areas without rheumatic heart disease, mitral valve prolapse (MVP) has been portrayed as the most common form of valvular h...