Considerations on the mechanism of the systolic click of mitral valve prolapse.

The Authors briefly discuss the mechanism of production of the systolic click of mitral valve prolapse. A "valvular" mechanism seems inadequate to explain the genesis of vibrations that can be recorded, not only in the external phonocardiogram, but also in the intraventricular pressure tracing, in the apex cardiogram, and even in the left atrial pulse (esophagus). It seems more logical to postulate that the force of deceleration created by the sudden eversion of a mitral leaflet set the whole cardiohemic system (blood, myocardial walls, and the mitral apparatus) into vibration, thus producing the click. In mitral valve prolapse, the contribution to sound production of mitral leaflets and chordae is likely to be minor, as it had been demonstrated for the first heart sound.