Skip to Main Content




  • Barlow syndrome

  • Floppy mitral valve

  • Mitral-click murmur syndrome

  • Systolic-click murmur syndrome




  • 424.0 Mitral valve disorders




  • I34.1 Nonrheumatic mitral (valve) prolapse




  • 6D: Impaired Aerobic Capacity/Endurance Associated With Cardiovascular Pump Dysfunction or Failure1



A 38-year-old woman presents with palpitations, anxiety, and dizziness. She states that nothing in particular has been causing her stress lately, but she feels her “heart racing.” Vitals are: Pulse: 84, Respirations: 18, Blood Pressure: 110/70, and SpO2% of 99%. On examination, there is an audible non-ejection click and a faint, late systolic murmur. On the musculoskeletal examination, there is a narrow anteroposterior chest diameter and a mild scoliosis. On echocardiogram, there is a 2.5-mm displacement of the mitral valve leaflet.




  • Abnormally thickened mitral valve that becomes displaced into left atrium during systolic contraction

  • Classic and nonclassic

    • Nonclassic carries low risk of complications

    • Complications of classic mitral valve prolapse (MVP) include mitral valve regurgitation, endocarditis, congestive heart failure, cardiac arrest


Mitral valve prolapse in an asymptomatic 8-year-old child. The cardiac echo demonstrated a mitral prolapse without regurgitation. Both the phonogram and spectrogram show a systolic mitral click and a diastolic S3 prominent during inspiration. (From Pahlm O, Wagner GS. Multimodal Cardiovascular Imaging: Principles and Clinical Applications. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
Essentials of Diagnosis

  • Stethoscope for auscultation systolic click in the mitral position, possible late systolic murmur

  • EKG/ECG2

  • Echocardiography

  • Exercise stress test

General Considerations

  • Education on disease management reduces hospitalization.

  • Patients with significant prolapse may show signs and symptoms of congestive heart failure.

  • Strenuous activity should be limited for symptomatic mitral prolapse.

  • Can lead to sudden cardiac death, arrhythmias, embolic events, and coronary disease.

  • Patients can develop bacterial endocarditis.

  • Mild-to-moderate prolapse generally does not cause symptoms.


  • Prevalent in 2% of thin female adolescents3

  • Equal incidence of classic and nonclassic

  • Equal incidence between genders and age groups

  • More common in patients with underlying genetic disease





  • Murmur accentuated with standing, hand-grip maneuver, Valsalva maneuver, and diminished with squatting

  • Cardiovascular collapse or shock

  • Angina pectoris4

  • Syncope4

  • Congestive heart failure4

  • Dyspnea on exertion

  • Shortness of breath4

  • Anginal chest pain that increases with exercise

  • Orthopnea4

  • Fatigue, weakness4

  • Fainting, dizziness with activity

  • Palpitations

  • Palpable heaves/thrills over precordium

  • Arrhythmias, particularly atrial fibrillation

  • Endocarditis

Functional Implications

  • Symptoms depend on degree of valvular dysfunction.

  • Severe ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.