Which statement about MVP is true?

Which statement about MVP is true?

• A. It is associated with a midsystolic click
• B. It is associated with a diastolic murmur
• C. It never has a click
• D. It is best heard at the right lower sternal border

Answer: (A)

Mitral valve prolapse produces a midsystolic click from the sudden tensing of the prolapsing mitral leaflets as they billow into the left atrium during systole. That click is often followed by a late systolic murmur if mitral regurgitation is present, but the key distinguishing feature is the midsystolic click itself. A diastolic murmur is not typical of MVP, since the abnormality affects systole. The murmor of MVP/MR is best heard at the apex (left fifth intercostal space in the midclavicular line) with the patient in the left lateral decubitus position, rather than at the right lower sternal border. Additionally, maneuvers that reduce venous return (like standing or Valsalva) make the click occur earlier in systole and often lengthen the murmur, while squatting or handgrip can shorten it. This constellation makes the midsystolic click the best and most characteristic finding for MVP.

Mitral valve prolapse produces a midsystolic click from the sudden tensing of the prolapsing mitral leaflets as they billow into the left atrium during systole. That click is often followed by a late systolic murmur if mitral regurgitation is present, but the key distinguishing feature is the midsystolic click itself. A diastolic murmur is not typical of MVP, since the abnormality affects systole. The murmor of MVP/MR is best heard at the apex (left fifth intercostal space in the midclavicular line) with the patient in the left lateral decubitus position, rather than at the right lower sternal border. Additionally, maneuvers that reduce venous return (like standing or Valsalva) make the click occur earlier in systole and often lengthen the murmur, while squatting or handgrip can shorten it. This constellation makes the midsystolic click the best and most characteristic finding for MVP.