girl^interrupted
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In mitral valve prolapse, If we squat i.e.increase the venous return ,(increasing preload).....I knw that the systolic murmur moves close to S2 b/c there's more blood.
What I dont knw is that on increasing preload, the murmur gets LOUDER or WEAKER?
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| usmle4me
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Should get louder
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| girl^interrupted
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r u positive???
b.c I also thought that it gets louder, goljan said so in his lec. but a friend thought it gets weaker just like hypertrophic cardiomyopathy
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| rock
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in MVP there is no change in murmur with squatting but in HOCM the murmur decreases as the hypertrophied muscle is now further apart and more towards normal because of the increased preload
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| girl^interrupted
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You're right about HOCM, but u've gotta check this about MVP, b/c goljan said so in his lecture.
I go for murmur getting louder in MVP with squatting.....I knw its in the lecture b.c I dont have time to listen to the lecture and find it in there....
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| rock
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well, kaplan step 2 notes has no change in murmur of MVP with squating and thats how i remembered it...but i shall check again from other sources too.
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| girl^interrupted
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Ok I checkd it....My friend was right
this from a common layman site:
Signs and tests Return to top
The doctor will perform a physical exam and use a stethoscope to listen to your heart and lungs. The doctor may feel a thrill (vibration) over the heart, and hear a heart murmur ("mid-systolic click"). The murmur gets louder when you stand up.
Blood pressure is usually normal.
The following tests may be used to diagnose mitral valve prolapse pr a leaky mitral valve:
* Echocardiogram
* Color-flow Doppler examination
* Cardiac catheterization
* Chest x-ray
* ECG (may show arrhythmias such as atrial fibrillation)
* Chest MRI
* CT scan of the chest
So the conclusion is:
....In HOCM as well as MVP, decresing preload, increases the intensity of murmur and vice versa....
whewww...Thnak God ists much easier to rem. that both of them have the same signs...
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| usmle4me
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yes checked out too ur friend and rock are right.
ok another explaination.
dec. preload...dec blood in ventricle..forceful contraction...inc mvp murmur. with inc preload...more time for isometric contrac to raise or not forcefull enough and causes less contr. dec intensity of murmur
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| rock
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thanks for checking it out and for the explanation.
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