Abstract
Flail mitral leaflet (FML) is a cause of mitral regurgitation, often in the context of myxomatous valve changes accompanied by chord rupture. Mitral regurgitation due to FML is reliably diagnosed by echocardiography, however there are specific auscultation features that help to identify this lesion. A holosystolic murmur with features of severe mitral regurgitation (MR), a grade 3 or 4, is often observed. Specific features include a decrescendo murmur with eccentric radiation, soft S1 and loss of click often associated with mitral valve prolapse. FML must be differentiated from other cardiac lesions such as aortic regurgitation, aortic stenosis, tricuspid regurgitation, Gallavardin Phenomenon, Ventricular Septal Defects and Corrected Transposition of Great Vessels. Management of mitral flail requires surgical intervention.
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References
Lembo N, Dell’Italia L. Bedside diagnosis of systolic murmurs. N Engl Med. 1988;318(24):1572–8.
Ling LH, Enriquez-Sarano M, Seward JB, Tajik AJ, Schaff HV, Bailey KR, Frye RL. Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med. 1996;335(19):1417–23.
Constant J. Bedside cardiology. 3rd ed. New York: Little Brown and Company; 1985.
Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Elsevier Saunders; 2011.
Ling LH, Enriquez-Sarano M. Long-term outcomes of patients with flail mitral valve leaflets. Coron Artery Dis. 2000;11(1):3–9.
Hammermeister KE, Fisher L, Kennedy W, Samuels S, Dodge HT. Prediction of late survival in patients with mitral valve disease from clinical, hemodynamic, and quantitative angiographic variables. Circulation. 1978;57:341–9.
Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2006;48(3):e1–148.
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MPV followed by MR in the setting of infective endocarditis, as described by Dr. W. Proctor Harvey (File 150 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved.) (MP4 3505 kb)
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Bunting, H., Murphy, M.E., Pemberton, H. (2015). Flail Mitral Leaflet. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_10
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DOI: https://doi.org/10.1007/978-1-4471-6738-9_10
Publisher Name: Springer, London
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