A 33-year-old man presents to the clinic with a complaint of fatigue and exertional chest pain for the past 3 weeks. He has been previously diagnosed with Ehlers-Danlos syndrome. He does not take any medications. Physical examination reveals a mid-systolic click and end-systolic murmur during cardiac auscultation.
Which of the following is the most likely cause of this patient’s cardiac examination findings?
The correct answer is:
B) Mitral valve prolapse
Mitral valve prolapse which presents with a mid-systolic click with possible end-systolic murmur. The click originates from when the mitral valve prolapses back into the left atrium during systole. The murmur happens afterwards if there is regurgitant flow.
Answer choice A: Aortic stenosis, is incorrect. Aortic stenosis delays the closing of the aortic valve, resulting in a paradoxical split.
Answer choice C: Tricuspid regurgitation, is incorrect. Tricuspid regurgitation allows a constant backflow of blood during systole and is described as a “holosystolic” or “pansystolic” murmur.
Answer choice D: Tricuspid stenosis, is incorrect. Tricuspid stenoss has a hallmark opening sound similar mitral stenosis as the stenotic valve is eventually forced open. This is then followed by a rumbling murmur during diastole.
Answer choice E: Ventricular septal defect is incorrect. Ventricular septal defect allows a constant backflow of blood during systole and is described as a “holosystolic” or “pansystolic” murmur.
Key Learning Point
Mitral valve prolapse presents with a mid-systolic click with possible end-systolic murmur. The click originates from when the mitral valve prolapses back into the left atrium during systole. The murmur happens afterwards if there is regurgitant flow.
