Echocardiographic diagnosis of mitral valve prolapse.

The present editorial, besides providing a historical review, offers a succinct definition and a new classification and terminology. It is hoped that this or a similar classification would clarify some of the confusion surrounding the diagnosis of mitral valve prolapse. The current echocardiographic criteria are reviewed. Some difficulty in the diagnosis of milder forms of prolapse is inevitable because a distinction between normal bulging and excessive hooding may be subtle in such cases. The proposed criteria using multiple echocardiographic cross sections (rather than the long-axis view alone) is more likely to provide a comprehensive visualization of several components of the leaflets and avoid errors of underdiagnosis of localized myxomatous prolapse abnormality. The criteria and discussion are based on the author's experience and interest in the diagnosis of this condition and clinical correlations with intraoperative findings. If the cardiac surgeons and the echocardiologists could agree on a common terminology and classification scheme, it could result in better anatomic correlations of the echocardiographic findings in this condition and potentially result in improved patient care.