Unlike chronic aortic regurgitation, acute regurgitation is generally poorly tolerated. Because the ventricle does not have sufficient time to dilate, the volume of blood flowing back into the ventricle produces a dramatic rise in end-diastolic pressure, which in turn produces signs and symptoms of heart failure. Acute aortic regurgitation generally requires early surgical treatment.
What physical findings are associated with mitral valve prolapse?
A mid-systolic click indicative of prolapse of the valve is the hallmark sign of this disorder. The click is followed immediately by a mid- to late-systolic murmur of mitral regurgitation which occurs once the valve leaflet has prolapsed into the atrium.
What maneuvers can be used to increase the murmur and click in mitral valve prolapse?
In general, maneuvers that increase left ventricular filling tend to make prolapse occur later in the cardiac cycle and decrease the intensity of the murmur. Maneuvers that decrease left ventricular filling have the opposite effect; they move the click earlier in systole and increase the murmur intensity. Therefore, a simple test is have the patient squat. This increases left ventricular filling and therefore moves the click later in the cycle and decreases the murmur. Then, while listening closely with the stethoscope, have the patient stand up from the squatting position. This will decrease left ventricular filling and increase of the murmur intensity while moving the click earlier in the cardiac cycle.
What are the echocardiographic findings?
The mitral valve should appear thickened. During systole, the valve leaflets prolapse superiorly into the left atrium. It may be associated with at least mild mitral regurgitation.
What about acute aortic regurgitation? Photo Gallery
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