What is the reason for hearing murmur in mitral valve prolapse
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mitral valve prolapse murmur mechanism systolic click late systolic murmur
In mitral valve prolapse (MVP), one or both mitral leaflets billow backward into the left atrium during systole because the leaflets and/or chordae tendineae are redundant or elongated.
- Midsystolic click: occurs when the prolapsing leaflet suddenly pulls the chordae tendineae taut.
- Late systolic murmur: after the leaflet has prolapsed, the mitral valve may no longer seal properly. Blood then leaks from the left ventricle back into the left atrium, producing turbulent flow, called mitral regurgitation.
So, the murmur is due to mitral regurgitation that begins after the onset of prolapse, which is why it is usually late systolic. If regurgitation is severe or there is a flail leaflet, it can become a holosystolic murmur. Goldman-Cecil Medicine, Physical Examination, p. 1084.
Does mitral valve prolapse always cause mitral regurgitation
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mitral valve prolapse not always mitral regurgitation authoritative
No. Mitral valve prolapse (MVP) does not always cause mitral regurgitation (MR).
MVP means the leaflet(s) move upward into the left atrium during ventricular systole. They may still meet and seal adequately, so there is no meaningful backward blood flow.
MR occurs only when the prolapse prevents effective leaflet coaptation, often because of more marked leaflet redundancy, annular dilatation, or elongated/ruptured chordae tendineae. When present, it may range from trivial to severe. Many people with MVP have no MR or only a very small, clinically insignificant leak. Miller's Anesthesia, Mitral Valve Prolapse, pp. 212-217.
The severity is assessed with Doppler echocardiography.
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