A midsystolic click heard best at the apex indicates which condition?

A midsystolic click heard best at the apex indicates which condition?

• A. Aortic stenosis
• B. Tricuspid regurgitation
• C. Mitral valve prolapse
• D. Pulmonic stenosis

Answer: (C)

A midsystolic click at the apex points to mitral valve prolapse. This happens when the mitral valve leaflets billow backward into the left atrium during mid to late systole, causing the sudden tension of the chordae tendineae that produces the click. The apex (left midclavicular line) is the best place to hear it, especially with the patient in the left lateral decubitus position. If mitral regurgitation accompanies MVP, you may also hear a late systolic murmur after the click. Other valvular diseases produce different sounds and timings: aortic stenosis gives a harsh systolic ejection murmur at the right upper sternal border without a click; tricuspid regurg gives a holosystolic murmur at the left lower sternal border; pulmonic stenosis presents with a systolic ejection murmur at the left upper sternal border.

A midsystolic click at the apex points to mitral valve prolapse. This happens when the mitral valve leaflets billow backward into the left atrium during mid to late systole, causing the sudden tension of the chordae tendineae that produces the click. The apex (left midclavicular line) is the best place to hear it, especially with the patient in the left lateral decubitus position. If mitral regurgitation accompanies MVP, you may also hear a late systolic murmur after the click.

Other valvular diseases produce different sounds and timings: aortic stenosis gives a harsh systolic ejection murmur at the right upper sternal border without a click; tricuspid regurg gives a holosystolic murmur at the left lower sternal border; pulmonic stenosis presents with a systolic ejection murmur at the left upper sternal border.