Mid-systolic click, late systolic murmur syndrome associated with complete heart block

Area of Science:

• Cardiology
• Cardiac Electrophysiology

Background:

• The mid-systolic click, late systolic murmur syndrome, also known as mitral valve prolapse, is a common cardiac condition.
• Heart block, a disruption in the heart's electrical conduction system, can range in severity.

Observation:

• A 60-year-old woman presented with symptoms suggestive of mitral valve prolapse.
• During an episode of non-anginal chest pain, advanced heart block was diagnosed.
• The patient subsequently required permanent transvenous pacemaker implantation.

Findings:

• The case demonstrates a documented association between the mid-systolic click, late systolic murmur syndrome, and advanced heart block.
• Phonocardiogram and left ventricular angiography confirmed the cardiac findings.

Implications:

• This association, though uncommon, warrants consideration in the clinical evaluation of patients with mitral valve prolapse.
• Recommend 24-hour continuous electrocardiographic monitoring and exercise stress testing for patients presenting with this syndrome.
• Early detection and management can improve patient outcomes and prevent serious cardiac events.