Аудіо 00067. Mitral valve prolapse

School physician has referred this child for investigation of gallop rhythm, i.e. abnormal heart sounds. A systolic click is heard but no murmur. Blood pressure is 97/55. During inspiration a diastolic murmur is also heard which is associated with mitral valve anomaly and which resembles S3 making the rhythm sound even more complicated. This child has no symptoms and ECG and chest radiograph are normal. On echocardiography a mitral valve prolapse is detected but no regurgitation. Both phono- and spectrogram show the systolic mitral click and diastolic S3 that is prominent in inspiration. Age 7.7 years, height 121.5 cm, weight 23.1 kg. Area of auscultation: Apex.