Transesophageal echocardiography during intraoperative evaluation of central hemodynamics in surgical treatment of ischemic heart disease

: Cardiac auscultation, phonocardiography, and two- dimensional echocardiography were performed in 32 patients who had sustained myocardial infarction in the presence of signs of mitral valve malfunction. Incomplete systolic closure of the mitral valve leaflets was detected in all the patients. The pattern of murmur appeared as its pansystolic and early systolic varieties. Apex rhomboid and late systolic murmurs were found in individual patients. The early systolic murmur was less loud and more frequently local than the pansystolic murmur. Twelve of 15 patients with the murmur proved to have an ++un-enlarged left ventricle. It is concluded that the occurrence of systolic murmur in the papillary muscle dysfunction syndrome is attributed to incomplete closure of the mitral++ valve. Left ventricular dilation results in transition of early systolic murmur to its pansystolic variant.