[Is this mitral valve prolapse? A case of mitral regurgitation with early systolic murmur due to early systolic prolapse of the posterior leaflet].

This paper reports the findings of phonocardiograms, echocardiogram and Doppler echocardiograms in a case of a 50-year-old man with early mitral valve prolapse with an early systolic murmur. A characteristic early systolic crescendo murmur was recorded at the apex. By amyl nitrite inhalation, the early systolic murmur was attenuated and a late systolic murmur was evoked. On the contrary, methoxamine injection increased the intensity of the early systolic murmur. Early systolic prolapse and early systolic buckling were recorded by two-dimensional and M-mode echocardiography. The phase of mitral regurgitation detected by M-mode color Dopper echocardiography coincided well in timing with the early systolic murmur and the early systolic buckling recorded on the M-mode echocardiogram. A discussion was made on the mechanism of the early systolic mitral regurgitation due to early mitral valve prolapse.