Prolapse of Both Mitral and Tricuspid Leaflets in Systolic Murmur-Click Syndrome

Abstract

Thirteen patients with proved prolapsed mitral leaflets were selected for right ventriculography to visualize their tricuspid valves. Twleve patients without prolapse were studied as controls. Six had late systolic prolapse of the tricuspid leaflets, most evident with the inferior leaflet. In one patient a clinical clue to the presence of tricuspid pathology was the appearance of a mid-late systolic murmur at the lower left sternal border after inspiration. Whether due to a primary derangement of valve anatomy or to vigorous or asynergistic ventricular contraction, the syndrome of prolapsed leaflets with myocardopathy can involve both atrioventricular valves.