Mitral valve stenosis class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient's condition deteriorates. Upon auscultation of an individual with mitral stenosis, the first heart sound is usually loud and may be palpable (tapping apex beat) because of increased force in closing the mitral valve. The first heart sound is made by the mitral and tricuspid heart valves closing. These are normally synchronous, and the sounds are termed M1 and T1, respectively. M1 becomes louder in mitral stenosis. It may be the most prominent sign. If pulmonary hypertension
Mitral insufficiency systolic regurgitant murmur may still be associated with significant hemodynamic consequences. The mitral valve apparatus comprises two valve leaflets, the mitral valve annulus, which forms a ring around the valve leaflets, and the papillary muscles, which tether the valve leaflets to the left ventricle and prevent them from prolapsing into the left atrium. The "chordae tendineae" are also present and connect the valve leaflets to the papillary muscles. Dysfunction of any of these portions of the mitral valve apparatus can cause regurgitation. The most common cause of MR in developing countries is mitral valve prolapse (MVP). and is the most