RT Journal
A1 Saffro R, Talano JV
T1 TRansient ischemic attack associated with mitral systolic clicks
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD June 1
VO 139
IS 6
SP 693
OP 694
DO 10.1001/archinte.1979.03630430069022
UL http://dx.doi.org/10.1001/archinte.1979.03630430069022
AB A 26-year-old woman was seen at Northwestern Memorial Hospital, Chicago, because of posterior occipital headache associated with right upper extremity paresis and dysarthria that lasted a period of ten minutes. Physical examination disclosed straightening of the thoracic spine and minimal pectus excavatum. Precordial examination showed midsystolic and late systolic clicks; the earlier click was followed by a soft grade 2/6 murmur. Neurological examination disclosed slight hyperreflexia on the right side.An M-mode echocardiogram of the mitral valve, performed the day after admission, is shown below (Fig 1). What is your diagnosis?Diagnosis.—Mitral Valve Prolapse (Barlow's Syndrome 
    )The patient had a normal echocardiogram, chest x-ray film, EEG, and EMI scan; results of platelet aggregation studies were also normal. A treadmill stress test was performed, which did not provoke arrhythmias. A 24-hour ambulatory ECG monitor showed slight predisposition to faster than expected resting sinus rates, but no supraventricular or ventricular arrhythmias.