Document Detail


Mid-systolic click and mitral valve prolapse following mitral commissurotomy.
MedLine Citation:
PMID:  629279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Five patients with rheumatic mitral stenosis were observed to have mid-systolic clicks with murmurs of mitral regurgitation at various intervals after mitral commissurotomy. In two patients echocardiography showed an unusually rapid posterior deflection of the mitral valve coinciding exactly with a systolic nonejection click. It is speculated that the shortened, fused chordae tendineae, compromised by mitral commissurotomy, rigidly hold the valve leaflets fixed at the onset of systole. During systole, ventricular conformational changes, in the face of marginal coaptation of thickened and fibrotic mitral leaflets, allow the mitral valve to be forced abruptly towards the left atrium with great velocity. This is manifested by a loud systolic click and, in some patients, a near vertical posterior systolic deflection of the mitral valve on the echocardiogram. The systolic click may occur without echocardiographic or angiographic evidence of mitral valve prolapse. Unusually loud mid-systolic clicks can be heard in patients with rheumatic heart disease after mitral commissurotomy and may be accompanied by a distinctive echocardiographic appearance of the mitral valve.
Authors:
J S Gottdiener; H S Sherber; W P Harvey
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  64     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1978 Feb 
Date Detail:
Created Date:  1978-04-26     Completed Date:  1978-04-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  295-300     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography
Female
Heart Auscultation
Heart Valve Diseases / diagnosis,  etiology
Humans
Male
Middle Aged
Mitral Valve
Mitral Valve Stenosis / pathology,  surgery*
Postoperative Complications*
Prolapse

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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