The significance of mitral valve prolapse in middle-aged and elderly men.

The clinical, roentgenographic, phonocardiographic, ECG, and echocardiographic data were evaluated in 40 consecutive middle-aged and elderly male patients with echocardiographically detectable systolic prolapse of mitral valve leaflets. Prolapse was present during more than half of systole in 31 patients and was holosystolic in six patients. In most instances, both leaflets prolapsed during systole. The closing velocity and excursion of the anterior leaflet were frequently increased particularly in association with evidence of mitral insufficiency. A majority of the patients had cardiac symptomatology. Moreover, roentgenographic and/or ECG evidence of cardiac enlargement or hypertrophy was evident in 45 percent of patients with mitral valve prolapse.