Ech'o-phonocardiographic Findings in Mitral Valve Prolapse*

Changes in left ventricular volume appear to be important in changing the timing and duration of mitral valve prolapse. In this study, simultaneous phonocardiograms and echocardiograms were recorded in 16 patients with late systolic mitral valve prolapse before and after the inflation of congesting cuffs (tourniquets) on the upper and lower extremities. The tourniquet application, known to reduce the venous return, caused a statistical1�1id-systolic clicks and late systolic murmurs are associated with systolic prolapse of the mitral valve leaflet (MVP) into the left atrium. Several articles noted the ability of postural changes and tilting’4 and nitrite administration5-8 to move the clicks and murmurs earlier in systole. The explanation proposed for this movement is a decrease in left ventricular volume (LVV), which allows earlier prolapse of the mitral valve.7 The application of constricting pneumatic cuffs (tourniquets) represents a simple, noninvasive procedure whereby venous return is diminished9 without any drug intervention, since the latter may have a direct effect on myocardial contractility. Review of the English literature failed to disclose data concerning the influence of tourniquets on LVV; however, reduction of venous return is expected to reduce LVV. The present study evaluates the effect of tourniquets on the phonocardiographic findings and echocardiograpkic heart dimensions in patients with MVP.