Murmur Upon auscultation of an individual with<unk> , a mid-systolic click, followed by a late systolic murmur heard best at the apex, is common. The length of the murmur signifies the time period over which blood is leaking back into the left atrium, known as regurgitation. A murmur that lasts throughout the whole of systole is known as a holo-systolic murmur. A murmur that is mid to late systolic, although typically associated with less regurgitation, can still be associated with significant hemodynamic consequences. In contrast to most other heart murmurs, the murmur of<unk>  is accentuated by standing and Valsalva maneuver (earlier systolic click and longer murmur) and diminished with squatting (later systolic click and shorter murmur). The only other heart murmur that follows this pattern is the murmur of hypertrophic cardiomyopathy. An<unk>  murmur can be distinguished from a hypertrophic cardiomyopathy murmur by the presence of a mid-systolic click which is virtually diagnostic of<unk> . The handgrip maneuver diminishes the murmur of an<unk>  and the murmur of hypertrophic cardiomyopathy. The handgrip maneuver also diminishes the duration of the murmur and delays the timing of the mid-systolic click. Both Valsalva maneuver and standing decrease venous return to the heart thereby decreasing left ventricular diastolic filling (preload) and causing more laxity on the chordae tendineae. This allows the<unk><unk>  to<unk>  earlier in systole, leading to an earlier systolic click (i.e. closer to S1), and a longer murmur.<unk>  syndrome Historically, the term<unk>  syndrome has been applied to<unk>  associated with palpitations, atypical precordial pain, dyspnea on exertion, low body mass index, and electrocardiogram abnormalities (ventricular tachycardia), syncope, low blood pressure, headaches, lightheadedness, exercise intolerance, gastrointestinal disturbances, cold extremities and other signs suggestive of autonomic nervous system dysfunction (dysautonomia).<unk>  regurgitation<unk>  can result in<unk>  regurgitation, shown here, in which blood abnormally flows from the left ventricle (1) back into the left atrium (2).<unk>  is frequently associated with mild<unk>  regurgitation, where blood aberrantly flows from the left ventricle into the left atrium during systole. In the United States,<unk>  is the most common cause of severe, non-ischemic<unk>  regurgitation. This is occasionally due to rupture of the chordae tendineae that support the<unk><unk> . The degree of<unk>  regurgitation severeness is usually estimated in grading system: * 0 (none or trivial) * Grade 1 (mild) * Grade 2 (moderate) * Grade 3 (moderate to severe) * Grade 4 (severe) Cardiac arrhythmia People with<unk>  might have arrhythmic<unk>  which includes higher incidence of ventricular contraction disorders and tachycardia compared to the normal population, although the relationship between both phenomena is not entirely clear.<unk>  of both<unk>  leaflets and the presence of<unk>  regurgitation further increases the risk of severe ventricular arrhythmias during exertion, which may not be resolved with surgery. The most common rhythm disorder is ventricular extrasystole, followed by paroxysmal atrial tachycardia. Sudden cardiac death Severe<unk>  and moderate-to-severe<unk>  regurgitation and reduced left ventricular ejection fraction is associated with arrhythmias and atrial fibrillation that can progress to cardiac arrest and sudden cardiac death (SCD). Because there is no evidence that<unk>  has contributed to these arrhythmias, these complications may be due to<unk>  regurgitation or congestive heart failure. The incidence of life threatening arrhythmias in the general population with<unk>  remain low. Sudden cardiac death results in 0.2% to 0.4% patients per year.
Mitral valve prolapse
Da Costa's syndrome  Da Costa's syndrome  1
Mitral regurgitation
Aortic regurgitation
Mitral stenosis
Tricuspid regurgitation
Tricuspid valve stenosis
Pulmonary valve stenosis