Alterations in S1-click interval and the character of the late systolic murmur during physiologic and pharmacologic maneuvers in mitral valve prolapse

Maneuvers	S1-click interval	Onset of late systolic murmur in relation to S1	Duration of late systolic murmur in relation to total duration of systole
Supine position	Increased	Late	Shorter
Standing position	Decreased	Early	Longer
Squatting*	Increased	Late	Shorter
Valsalva (phase 2)	Decreased	Early	Longer
Hand grip	Increased	Late	Shorter
Postectopic beat	Usually decreased	Usually late	Usually longer
Amyl nitrite	Decreased	Early	Longer
Phenylephrine	Increased	Late	Shorter

Maneuvers_mitral_valve_prol.htm

* The delay in the onset of the click and a shortening of the late systolic murmur with squatting reflects a delay in prolapse induced by the increase in preload; the reverse changes occur with standing. However, as mitral regurgitation becomes more severe, the murmur may increase in intensity with squatting because of the increase in afterload.

Graphic 75155 Version 1.0

خرید پکیج

Alterations in S1-click interval and the character of the late systolic murmur during physiologic and pharmacologic maneuvers in mitral valve prolapse