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Mitral valve prolapse
- mid-late systolic murmur
- only murmur that changes with posture
- earlier on standing
- later on lying
Complications
- endocarditis
- rupture
- arrhythmias
Prognosis
- regression - 11%
- can regress with large reduction in afterload / BP
- progression -51%
- predictive of progression
- asymptomatic are stable
- symptomatic 5 year survival 50-60%
Signs
- Left atrium and left ventricular dilatation (shifted apex)
- Pansystolic murmur
Management
Medical
- vasodilators
- nifedipine
- ACE-inhibitors
Surgical
- mitral valve repair / replacement
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