15- barlow's syndrome

- other name for MITRAL VALVE PROLAPSE

- other synonyms for the same syndrome are SYSTOLIC CLICK MURMUR SYNDROME , FLOPPY VALVE SYNDROME OR BLOWING MITRAL LEAF LET SYNDROME .

- frequent finding in patients with heritable disorders of connective tissue including the MARFANS SYNDROME , OSTEOGENESIS IMPERFECTA AND EHLER DAHNLOS SYNDROME .

-in most patients the cause is unknown , but in some it appears to be a genetically determined collagen tissue disorder . a reduction in the production of type 3 collagen has been incriminated.

- more common in females

- most commonly affects individuals between 14 and 30 years .

- most patients are asymptomatic and remain so for their entire lives . clinical features may range from only a systolic click and murmur and mild prolapse of the posterior leaf let of the mitral valve to severe MR due to chordal rupture and massive prolapse of both the mitral leaflets .

- most common cause of isolated severe MR requiring surgical treatment in north america .

-sudden death is a very rare complication .

- the most important auscultatory finding is the mid or late nonejection systolic click which occurs 0.14 seconds or more after the S 1 and is thought to be generated by the sudden tensing of slack , elongated chordae tendinae or by the prolapsing mitral leaf let when it reaches its maximum excursion.

- two dimensional echocardiography is particularly effective

- chestpain may be present and may be reduced by beta blockers .