The significance of late systolic murmurs

Barlow, John B.; Pocock, Wendy A.; Marchand, Paul; Denny, Mary Carter

doi:10.1016/0002-8703(63)90375-2

Cited by 373 publications

(70 citation statements)

References 22 publications

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“…Since Barlow's description, 13) a variety of names have been given to mitral valve prolapse, including the click-murmur syndrome, the floppy mitral valve syndrome, myxomatous mitral valve, and idiopathic mitral valve prolapse. Although most cases appear to be sporadic, echocardiographic screening of families for MVP has suggested autosomal dominant inheritance of the trait with an age and sex dependent expression.…”

Section: Discussionmentioning

confidence: 99%

Lack of Association Between Perlecan Gene Intron 6 BamHI Polymorphism and Risk of Mitral Valve Prolapse in Taiwan Chinese

Chou¹,

Chen²,

Wu³

et al. 2004

Jpn Heart J

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SUMMARYAbnormalities of proteoglycan, collagen, and elastic fibers were found in floppy mitral valves. Perlecan is one of the three major classes of heparan sulfate proteoglycans within the cardiovascular system. The role of perlecan genetic variant in mitral valve prolapse (MVP) has not been studied. We therefore performed a case-controlled study investigating the possible relation between the perlecan gene intron 6 BamHI polymorphism and MVP among the Chinese population in Taiwan.We studied 100 patients with MVP diagnosed by echocardiography and 100 age-and sex-matched normal control subjects. The perlecan gene intron 6 BamHI polymorphism was identified by polymerase chain reaction-based restriction analysis.There were no significant differences in either the genotype distribution or allelic frequencies between MVP cases and controls for perlecan gene intron 6 BamHI polymorphism (P = 0.20 and 0.76, respectively). Further categorization of the MVP patients into mild and severe subgroups also revealed no statistical difference from controls for perlecan gene intron 6 BamHI polymorphism.It is concluded that perlecan gene intron 6 BamHI polymorphism is not a suitable genetic marker of MVP in Taiwan Chinese (Jpn Heart J 2004; 45: 109-118)

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Section: Discussionmentioning

confidence: 99%

Lack of Association Between Perlecan Gene Intron 6 BamHI Polymorphism and Risk of Mitral Valve Prolapse in Taiwan Chinese

Chou¹,

Chen²,

Wu³

et al. 2004

Jpn Heart J

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“…Now that the association between these two syndromes is fairly well established, one wonders if the initial studies of these two syndromes were actually partial descriptions of only one syndrome! Perhaps Reid (1961) and Barlow (1965) concentrated much on the origin of the auscultatory abnormalities of MVP syndrome and thereby failed to pay attention to the coexisting skeletal abnormalities (straight back, scoliosis, and pectus) which are now considered important nonauscultatory clinical features of the MVP syndrome (Bon et al, 1975;Solomen er al., 1975). Similarly, could Rawlings have focused more on the skeletal abnormalities, and thereby failed to note the auscultatory features of MVP syndrome as we know it today?…”

Section: One Complex or Two Different Syndromes?mentioning

confidence: 99%

The “straight back” syndrome: Current perspective more often associated with valvular heart disease than pseudoheart disease: A prospective clinical, electrocardiographic, roentgenographic, and echocardiographic study of 50 patients.

Ansari¹

1985

Clinical Cardiology

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Summary: Fifty consecutive patients (36 male, 14 female, mean age 28 years) who had heart murmurs and clinical and radiographic evidence of straight upper dorsal spine (straight back syndrome, SBS) underwent detailed clinical, electrocardiographic, roentgenographic, and echocardiographic evaluation. Palpable systolic thrill noted in one (2%) and widened S2 with persistent splitting in 2 (4%) patients were uncommon. Murmurs were invariably systolic in nature. Those located at the base of the heart in 19 (38%) patients were ejection in type and best heard during expiration. Those located at the apex in 26 (52%) patients were either mid-, late-, or pansystolic, and often associated with midsystolic click. Five (10%) patients had both types of murmurs. Diastolic murmurs were not heard in any patient. EKGs were normal in the majority. Cardiornegaly (C:T>55%) was present in only 5 (10%) and dilatation of the main pulmonary artery in 2 (4 %) patients. Thus the incidence of pseudoheart disease (PsHD) was

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“…In-two patients it is possible that digoxin was responsible for the cardiographic abnormality. 11, Ill, aVL B) Exercise ECG. The mean duration of exercise was 6.6 minutes (7.6 for men and 4.9 minutes for women).…”

Section: Electrocardiographymentioning

confidence: 99%

Electrocardiography and Echocardiography in Patients with Chest Pain and Mitral Leaflet Prolapse

1985

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SUMMARY: 34 patients with catheter verified, haemodynamically trivial mitral leaflet prolapse with chest pain and normal I coronary arteries were studied. Nineteen had no auscultatory signs of MLP despite clear catheter or ec.hocardiographic evidence of prolapse. Infero-Iateral repolarisation changes on the resting electrocardiogram were present In 29070.50% .had faIse positive exercise tests. M-mode echocardiography proved diagnostically disappointing but sector scans reve~led mltr~1 leaflet prolapse in 62%. The apical 4 chamber acoustic window was markedly superior to the parasternal long aXIs acoustic window. IntroductionIdiopathic mitral leaflet prolapse (MLP) is a common cardiac abnormality with a prevalence of between 5% and 18% depending upon the race, age and sex of the population studied and the diagnostic methods and criteria employed l -IO • The diagnosis must be considered in patients complaining of chest pain, palpitations, dyspnoea, syncope or transient neurological events particularly if objective findings such as thin body habitus, non-ejection systolic clicks or non-ejection systolic murmurs are also present"-17 • The diagnosis is usually based upon ausculatory findings supported by non-invasive investigations particularly echocardiographyI8.25. Errors in technique and flexibility in data interpretation have however led to considerable diagnostic confusion. This seems to be particularly the case when chest pain dominates the clinical picture as symptomatology and electrocardiography may strongly suggest coronary heart disease. This study attempts to evaluate the role of resting and exercise electrocardiography and M-mode and 2-dimensional echocardiography in patients with mitral leaflet prolapse and angiographically normal coronary arteries presenting with chest pain.

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The significance of late systolic murmurs

Cited by 373 publications

References 22 publications

Lack of Association Between Perlecan Gene Intron 6 BamHI Polymorphism and Risk of Mitral Valve Prolapse in Taiwan Chinese

Lack of Association Between Perlecan Gene Intron 6 BamHI Polymorphism and Risk of Mitral Valve Prolapse in Taiwan Chinese

The “straight back” syndrome: Current perspective more often associated with valvular heart disease than pseudoheart disease: A prospective clinical, electrocardiographic, roentgenographic, and echocardiographic study of 50 patients.

Electrocardiography and Echocardiography in Patients with Chest Pain and Mitral Leaflet Prolapse

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