Why the study?
Should antimicrobial prophylaxis against infective endocarditis be given to patients with mitral valve prolapse who have a late systolic murmur rather than only those with a holosystolic murmur?
Should antimicrobial prophylaxis against infective endocarditis be given to patients with mitral valve prolapse who have a late systolic murmur rather than only those with a holosystolic murmur?
The author argues that antimicrobial prophylaxis for infective endocarditis should be considered in mitral valve prolapse patients with late systolic murmurs, as they also exhibit mitral regurgitation.
Letters and Corrections1 July 1986Antimicrobial Prophylaxis in Mitral Valve ProlapseHENRY SCHNEIDERMAN, M.D.HENRY SCHNEIDERMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-1-142_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. Kaye's recent update on prophylaxis against infective endocarditis (1) is well considered and practical. One suggestion therein deserves further exploration: the possible limiting of prophylaxis to those patients with mitral valve prolapse having a holosystolic murmur. Presumably, this proposal assumes that only holosystolic murmurs indicate mitral regurgitation and thereby the predisposition to infection (2). However, the literatures on physical diagnosis and on mitral prolapse (3-5) argue that mitral regurgitation occurs even in patients and cycles having only a late systolic murmur. In these instances, the valve is competent early in systole but "leaks" at end systole....References1. KAYE D. Prophylaxis for infective endocarditis: an update. Ann Intern Med. 1986;104:419-23. LinkGoogle Scholar2. WEINSTEINSCHLESINGER LJ. Pathoanatomic, pathophysiologic and clinical correlations in endocarditis. N Engl J Med. 1974;291:832-7, 1122-6. CrossrefMedlineGoogle Scholar3. SELZER A. Nonrheumatic mitral regurgitation. Mod Concepts Cardiovasc Dis. 1979;48:25-30. Google Scholar4. JERESATY R. Mitral Valve Prolapse. New York: Raven Press; 1979:47-52. Google Scholar5. CRISCITIELLO M. Physiologic and pharmacologic aids in cardiac auscultation. In: FOWLER NO, ed. Cardiac Diagnosis and Treatment. 3rd ed. Hagerstown, Maryland: Harper and Row, Publishers; 1980:77-90. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Connecticut Health Center Farmington, CT 06032 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1986Volume 105, Issue 1Page: 142-142KeywordsAntimicrobialsEndocarditisMitral insufficiencyMitral valve prolapseProphylaxisSystoleSystolic ejection murmur Issue Published: 1 July 1986 PDF DownloadLoading ...
No takes yet. Share an insight, caveat, or question.
Henry Schneiderman (1986) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: