Fundamentals of Heart Sounds

Mitral Valve Leaflet Prolapse Lesson #640

patient thorax when auscultating by stethoscope

The patient was supine during auscultation.

Description

In this case, a mid-systolic click is immediately followed by a late systolic diamond-shaped murmur that runs to the end of systole. The intensity of the murmur increases and its starting point begins earlier in systole as left ventricular volume decreases (going from supine to standing).

On the anatomy video you can see that the murmur is caused by the prolapse of the posterior mitral valve leaflet. The murmur is represented by turbulent flow from the left ventricle into the left atrium.

Phonocardiogram

Anatomy

Mitral Valve Leaflet Prolapse

Play the animation and take note of the prolapse of both the anterior and posterior mitral valve leaflets and turbulent flow across the incompetent mitral leaflets (murmur of mitral regurgitation).

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/10/2021

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com