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
Mitral insufficiency broad, notched P waves in several or many leads with a prominent late negative component to the P wave in lead V, and may be seen in MI, but also in mitral stenosis, and, potentially, any cause of overload of the left atrium. Thus, "P-sinistrocardiale" may be a more appropriate term. The degree of severity of MR can be quantified by the regurgitant fraction, which is the percentage of the left ventricular stroke volume that regurgitates into the left atrium. where V and V are, respectively, the volumes of blood that flow forward through the mitral valve and aortic valve