Mitral valve prolapse virtually diagnostic of MVP. The handgrip maneuver diminishes the murmur of an MVP 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 mitral valve to prolapse earlier in systole, leading to an earlier systolic click (i.e. closer to S), and a longer murmur. Historically, the term mitral valve prolapse syndrome has been applied to MVP associated
Gold Is Where You Find It Gold Is Where You Find It Gold is Where You Find It is a 1938 American romantic drama film directed by Michael Curtiz and starring George Brent, Olivia de Havilland, and Claude Rains. Based on a story by Clements Ripley, with a screenplay by Warren Duff and Robert Buckner, the film is about the rivalry between farmers and miners in the Sacramento valley 30 years after the California Gold Rush. The feud between the two factions is complicated when a man from one side and a woman from the other fall in love. This Technicolor feature film was released on