Angiocardiography in the apical systolic click syndrome. Left ventricular abnormality, mitral insufficiency, late systolic murmur, and inversion of T waves.

Abstract

Mitral insufficiency is characteristically associated with a high-pitched, apical pansystolic murmur which radiates toward the left axilla and subscapular areas. Murmurs heard in late systole and systolic clicks were considered benign and were thought to originate in extracardiac structures (9), possibly related to pleural and pericardial disease. Recently, however, it has been demonstrated that a number of patients with late apical systolic murmurs, whether initiated by a click or not, have varying degrees of mitral insufficiency. A late apical systolic murmur may be heard in rheumatic mitral insufficiency, subaortic stenosis, coarctation of the aorta, and postmyocardial infarction and with a calcified mitral annulus associated with mitral insufficiency. The cases being reported are all in young females without previous history of congenital or acquired cardiac disease. The term “click” is used to describe a very short, high-pitched systolic clicking sound. This term was introduced by Gallavardin (5) in ...