Late systolic murmurs and clicks associated with abnormal mitral valve ring

Abstract

An anomaly of the mitral valve was identified in 7 patients with apical mid-late systolic murmurs, with or without associated clicks. This consisted primarily of a large annulus, probably congenital in origin, with secondary abnormal systolic protrusion of the leaflets, which permitted minimal mitral regurgitation in 5 of the 7 cases. It is possible to recognize a triad of auscultatory, electrocardiographic (inverted T wave in lead III) and angiographic signs that make possible the diagnosis of this hemodynamically benign entity.