Аудіо 00068. Mitral valve prolapse and regurgitation

Echocardiography shows mitral valve prolapse and minor mitral regurgitation. This child was referred for acute investigations because of a suspicious murmur. ECG and chest radiograph were, however, normal. At the time of investigation the child is fearful and the murmur varies with body position and is not heard when lying down. On echocardiography papillary muscles are normal, the range of movement of the posterior mitral cusp is wide, and minor, narrow-based posterior regurgitation is seen. The murmur is systolic and second-degree at the most, at the end of the systole a high-pitched squeak is heard. On the phonogram the sound becomes louder towards the end of systole and, similarly, the frequency grows on the spectrogram. This sound differs from the vibration squeak by being clearly higher, over 500 Hz, and by occurring at endsystole. There is mitral regurgitation that is one fifth of the length of the left ventricle. Age 3.6, height 100.0 cm, weight 15.0 kg. Area of auscultation: left third ic.