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Relationship between clinical and echocardiographic criteria for mitral valve prolapse reevaluation employing the parasternal long axis view

Relationship between clinical and echocardiographic criteria for mitral valve prolapse reevaluation employing the parasternal long axis view

American Journal of Noninvasive Cardiology 4(2): 91-96

To reassess the relationship between clinical and echocardiographic criteria for mitral valve prolapse (MVP), the auscultatory and two-dimensional echocardiographic findings in 106 patients suspected of having MVP were studied. Employing the parasternal long-axis view as the gold standard, 44% of the patients were found to have MVP, 6% had mitral regurgitation without prolapse, and 50% had a normal examination. Sensitivity and specificity of cardiac findings varied considerably. The constellation of a non-ejection click and/or apical systolic murmur had the highest sensitivity (91%) in detecting echocardiographic MVP, but specificity and positive predictive value were 41 and 55%, respectively. The presence of an isolated click was the most specific sign (88%), but the sensitivity was 19%. The positive predictive values for all ausculatory criteria ranged between 50 and 60%. These data again question the validity of ausculatory findings as the basis for definitive diagnosis of MVP and heighten concern about the potential impact of falsely labeling patients.

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