ABSTRACT
Thirty five patients with mitral valve prolapse [25 males and 1O females with a mean age of 24.7 years] were examined clinically and with echocardiography. ECG and chest X-rays were done when needed. 71.4% of these patients were asymptomatic while 28.6% presented with variable complaints; the most predominant were atypical chest pain and palpitation. On auscultation, silent prolapse was found in 17.2%, while 82.8% showed variable auscultatory findings, 20% in the form of isolated apical systolic murmur or apical systolic murmur with systolic click. Echocardiographic examinations showed that M-mode echocardiography [MME] was diagnostic in 86% of these cases while two dimensional echocardiography [2-DE] was diagnostic in 57%. On 2-DE examinations, the apical 4-chamber view was sensitive in 90% of cases diagnosed with this technique. Sagging of leaflets toward the left atrium in systole was the hallmark for diagnosis, while in MME sagging of leaflets was evidenced by systolic buckling, separation of closure lines more than 3.9 mm beyond the C-D plane, or multiple systolic closure lines. Standing provoked the echocardiographic evidence of prolapse in 2 patients with strong clinical suspicion. Echocardiographic assessment of patients with clinical suspicion of mitral valve prolapse is necessary to confirm diagnosis and detect complications