Mitral-valve prolapse syndrome

THE MITRAL-VALVE prolapse (MVP) syndrome is a relatively recently recognized association of various signs and symptoms. Systolic clicks, late systolic murmurs, or both have been heard by clinicians for a number of years. More than ten years ago, patients with these auscultatory findings were found to have angiographic evidence of billowing of the mitral-valve leaflets toward the left atrium during systole, frequently in association with mild mitral regurgitation.¹This led to the use of these auscultatory findings as the sine qua non of the syndrome. The recent identification of preclinical and mildly symptomatic forms of MVP by echocardiography has stimulated us to reassess this condition.²We now realize that this syndrome is composed of many signs and symptoms, causing only minor degrees of disability at times. This article enumerates the elements of this fascinating syndrome as classically described and adds information gained by echocardiography. This additional information broadens