Jul 3, 2014
I had some problems with this question found in qbank. Before i say my answer i would know yours. So...

A 25 yo woman, asymptomatic, is discovered to have: midsystolic click and high pitched murmur.

Witch of the following cardiovascular findings is she most likely to exhibit?

Atrial fibrillation
Decreased peripheal pulse pressure
Premature ventricular contractions
Slowed carotid upstroke
Wide pulse pressure

so what would it be your answer?


10+ Year Member
7+ Year Member
Mar 23, 2009
MD/PhD Student
If I had to take a guess, I'd say it's a mitral regurgitation so you may have decreased peripheral pulse pressure.
Jul 3, 2014
the correct answer is c: premature ventricular pressure.

But I would have aswered B, too.
Mid-S. Click is a sign of mitral prolapse.
it can't be atrial fibrillation, it is associated with mitral stenosis. Slowed carotid upstroke and wide pulse pressure respectively with aortic stenosis and regurgitation. Decreased peripheal PP can be associated with a decreased cardiac output,that is what happens in a mitral prolapse.

I really don't know why it is C
Jul 3, 2014
Uh, I found this: http://circ.ahajournals.org/content/52/1/73.full.pdf

This isn't something I'd heard about before. Where is this question from?
It is from usmle step 1 qbook sixth edition, page 329. Question number 42.

The explanation doesn't say why it is c, but it says: decreased peripheal pulse pressure and slowed carotid upstroke are seen in aortic valve stenosis. A systolic ejection click is associated this valvular disease........

EDIT Robbins says only that the mitral prolapse can have as a complications atrial and ventricular arrhythmias.
Anyway I still have doubts :(
Last edited:


5+ Year Member
Jan 30, 2013
North of the Wall
Resident [Any Field]
"Symptoms" of MVP are collectively known as MVP syndrome and include atypical chest pain, dyspnea, palpitations and paresthesias. Makes sense right? Not really?

There's something of a controversy over whether or not mitral valve prolapse syndrome exists at all. Most of the studies describing the syndrome suffer from design flaws/selection bias. All of the more recent controlled clinical studies (including Framingham!) have found no discernible difference in symptomology between patients with prolapse and those without.

What does that mean for you? Consider MVP syndrome to be outmoded dogma that you need to know only to answer test questions but avoid in clinical practice. File it away in your brain right next to Homans sign.


giants fan
5+ Year Member
Dec 14, 2013
People with MVP have higher incidence of PVCs(premature ventricular contractions), cause unknown, but they are benign.