Clinical communicationSystolic clicks and the late systolic murmur: Intracardiac phonocardiographic evidence of their mitral valve origin☆
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Cited by (53)
Cardiac Auscultation: Rediscovering the Lost Art
2008, Current Problems in CardiologyCitation Excerpt :Likewise, beta-blocking agents (frequently used to treat these patients) decrease heart rate and contractility and increase ventricular volume (allowing more time for ventricular filling) and may attenuate or abolish the classic auscultatory findings of MVP. These auscultatory phenomena, therefore, may help explain why patients with MVP may have no acoustic findings on one occasion yet prominent findings on another.157-162 Rheumatic fever is the major cause of MS. Although we have witnessed a dramatic decline in acute rheumatic fever in the United States (due to control of group A streptococcal infection), strep infections and acute rheumatic fever have recently reemerged as clinical problems.
The diagnosis of heart disease by clinical assessment alone
2002, Disease-a-MonthCitation Excerpt :Trivial or mild MR is usually late systolic in timing and may be preceded by mid-systolic click(s) (Figure 21, C). In a young, otherwise healthy female patient of asthenic body habitus, with pectus excavatum, straight back, kyphoscoliosis, hypomastia, and hypermobility of the joints, with or without complaints of atypical chest pain, dyspnea, fatigue, palpitations, anxiety, panic reactions, orthostatic dizziness, and transient cerebral ischemic episodes, the examiner should listen specifically for mid-systolic click(s) and a mid to late or holosystolic murmur or musical ″whoop” or ″honk” of MVP.243-246 As previously discussed, multiple positions, including standing (earlier click, longer and louder systolic murmur) and squatting (later click, shorter and softer murmur), may be required to ″bring out” these auscultatory features.
Foreword: Current Problems in Cardiology
2001, Current Problems in CardiologyCardiac auscultation. A cost-effective diagnostic skill
1995, Current Problems in CardiologyAtypical systolic clicks produced by prolapsing mitral valve masses
1992, The American Journal of CardiologyThe floppy, myxomatous mitral valve, mitral valve prolapse, and mitral regurgitation
1991, Progress in Cardiovascular Diseases
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This investigation was supported in part by Public Health Service Research Career Program Award HSG 14,009 and by Public Health Service Grant H-3319 from the National Institutes of Health, Bethesda, Md.
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Georgetown University Hospital, 3800 Reservoir Rd., N.W., Washington, D. C., 20007.