Echocardiographic Patterns in Patients with the Syndrome of Systolic Click and Late Systolic Murmur

Re, Kerber; Dm, Isaeff; Ew, Hancock

doi:10.1056/nejm197104012841303

Cited by 184 publications

(11 citation statements)

References 12 publications

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“…30,31 Although the late systolic posterior leaflet displacement has been described as a specific diagnostic criterion, it has been shown that it actually was insensitive and could be produced in 40% to 55% of normal subjects depending on the transducer position on the chest. 32,33 Some investigators who studied the reliability of this method obtained discouraging results.…”

Section: M-mode Echocardiographymentioning

confidence: 99%

Does the Association Between Mitral Valve Prolapse and Panic Disorder Really Exist?

Filho¹,

Maciel²,

Martín‐Santos³

et al. 2008

Prim. Care Companion J. Clin. Psychiatry

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Section: M-mode Echocardiographymentioning

confidence: 99%

Does the Association Between Mitral Valve Prolapse and Panic Disorder Really Exist?

Filho¹,

Maciel²,

Martín‐Santos³

et al. 2008

Prim. Care Companion J. Clin. Psychiatry

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“…The morphologic characteristics of the Marfan syndrome were present in one boy and four girls (three had an affected parent, none had affected siblings). '8 19 Although the remaining 21 patients had normal height and weight distribution, six were noted to have minor musculoskeletal abnormalities (pectus excavatum) (4), high arched palate (1), arachnodactyly with hyperextensible joints (2). In none of the patients was there a history of rheumatic fever or clinical evidence of other cardiac abnormalities.…”

Section: Patient Materialsmentioning

confidence: 99%

Mitral valve prolapse in children: a problem defined by real-time cross-sectional echocardiography.

Sahn¹,

Allen²,

Goldberg³

et al. 1976

Circulation

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The cross-sectional echocardiographic features of mitral valve prolapse were defined in 26 children (ages 2-18 years) using a real-time, multiple-crystal ultrasound scanner. In each patient the physical findings of the mitral valve click-murmur syndrome were present and mitral valve prolapse had been diagnosed previously by conventional single crystal echocardiography. Mitral prolapse occurred in a familial setting in eight patients and was associated with the Marfan syndrome in five. Real-time two-dimensional echocardiography uniformly disclosed maximum mitral arching and the superior-posterior prolapse. These visual observations were confirmed by M-mode recordings derived from single elements within the array of 20 crystals. The method allowed a complete M-mode description of the phasic motion of the entire mitral apparatus and observations of the spectrum of prolapse from discrete late systolic prolapse to "hammock-like" holosystolic prolapse. Further, the recording of multiple systolic M-mode lines occurred when the ultrasound beam intersected the arched leaflets more than once. Pseudosystolic anterior motion was observed often and resulted clearly from a superimposition of echoes from the mitral annulus and from the posterior-superiorly arched prolapsed leaflets. A major finding in 22 patients was the association with prolapse of biconvex enlargement of the aortic sinuses of Valsalva and a significant increase in the diameter of the aortic root. Aortic root dilatation was most marked in, but not confined to, patients with the Marfan syndrome and was a prominent finding in six patients with minor musculoskeletal abnormalities. The presence of aortic root dilatation in children with normal body habitus raises important questions concerning the generalized nature of an abnormality of cardiac connective tissue in patients with mitral prolapse. The cross-sectional approach significantly enhances the noninvasive evaluation of mitral valve prolapse and provides an explanation for many of the single crystal observations reported previously.

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“…After the introduction of echocardiography, first Mmode [12] and later two-dimensional (2D-echo), MYP patterns were described [13], while Gilbert et al [14] cor related the 2D-echo diagnosis with LV angiography. Since then innumerable échocardiographie studies have been published, and MVP has become an échocardiographie diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Mitral Valve Prolapse: A Comparative Study with Two-Dimensional and Doppler Echocardiography, Auscultation, Conventional and Esophageal Phonocardiography

Chin¹,

Herpen²,

Vermariën³

et al. 1992

Am J Noninvas Cardiol

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The diagnosis of mitral valve prolapse (MVP) still lacks a rigorous definition by standard criteria which take into account the complete set of investigative methods available. We did a comparative study of noninvasive methods, including our technique of quantitative esophageal phonocardiography (ePCG). A group of 40 patients who previously had a diagnosis of MVP by M-mode echocardiography took part in the study. These patients were examined by two-dimensional echocardiography (2D-echo) and Doppler echocardiography, immediately followed by auscultation, ePCG and a conventional phonocardiogram (ePCG). In 9 cases the M-mode diagnosis was dubious; none of these had any other sign of MVP. In 18 cases MVP was confirmed by 2D-echo, 13 of them with mitral regurgitation (MR) according to the Doppler study. All 18 cases were identified as MVP in the ePCG by the presence of a midsystolic click (MSC, n = 2), a late systolic murmur (LSM, n = 3), or both (n = 13). Moreover, 3 cases classified as negative by 2D-echo and Doppler were found positive (MSC + LSM) for MVP by ePCG. Auscultation revealed a MSC (n = 3), a LSM (n = 5), or both (n = 5) in 13 of the 18 2D-echo-positive cases; in addition in 1 of the 2D-echo-negative cases a LSM was heard. The ePCG was positive by MSC (n = 3), LSM (n = 4) or both (n = 4) in 11 of the 18 cases. ePCG thus proved to be more sensitive in diagnosing MVP than auscultation and ePCG, and even than 2D-echo plus Doppler. In 2 of the 3 ‘overdiagnosed’ cases, where the ePCG was positive and 2D-echo and Doppler were not, there was other evidence for a diagnosis of MVP.

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Echocardiographic Patterns in Patients with the Syndrome of Systolic Click and Late Systolic Murmur

Cited by 184 publications

References 12 publications

Does the Association Between Mitral Valve Prolapse and Panic Disorder Really Exist?

Does the Association Between Mitral Valve Prolapse and Panic Disorder Really Exist?

Mitral valve prolapse in children: a problem defined by real-time cross-sectional echocardiography.

Mitral Valve Prolapse: A Comparative Study with Two-Dimensional and Doppler Echocardiography, Auscultation, Conventional and Esophageal Phonocardiography

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