Guide To Heart Murmurs: Mitral Valve Prolapse Murmur

 WHAT IS IT?

A mitral valve prolapse murmur is a self descriptive term. It refers to a heart murmur caused by the regurgitation of blood from the left ventricle to the left atrium (through a prolapsed mitral valve).

Source
WHAT CAUSES IT?

This heart murmur can be caused by:

  • Myxomatous degeneration: caused by connective tissue disorders such as Marfan syndrome or Ehlers-Dalos syndrome
  • Rheumatic fever
  • Chordae rupture 
FEATURES OF AUSCULTATION

Where to listen: this murmur is typically heard best at the apex of the heart. 

Classically an mitral valve prolapse murmur is heard best at the apex of the heart and can radiate to the axilla (source).

When to listen: this is a midsystolic murmur and can be best appreciated during systole (BEGINS after S1 and ENDS at S2)

What to listen for: typically this murmur is described as a late systolic crescendo murmur with a mid systolic click. It is loudest just before S2. 

A mitral valve prolapse murmur begins with a mid-systolic click and then increases in intensity until the S2 heart sound (source).
IMPACT OF BEDSIDE MANEUVERS ON THIS MURMUR

Various bedside movements can be performed that can help inform what type of murmur is present. The following maneuvers will have the listed effects on an aortic stenosis murmur:

  • Hand grip will cause the later onset of the click/mrmur
  • Valslava will cause the earlier onset of the click/murmur 
  • Standing up will cause the earlier onset of the click/murmur 
  • Rapid squatting will cause the later onset of the click/mrmur

 

Page Updated: 02.19.2017