[Meso-telesystolic sounds in children]

Area of Science:

• Pediatric Cardiology
• Cardiovascular Pathology

Background:

• Meso-telesystolic clicks are frequently observed in children.
• These clicks often present with late systolic murmurs and specific left ventricular myocardial alterations.

Purpose of the Study:

• To investigate the underlying pathogenetic mechanism of the meso-telesystolic click, late systolic murmur, and associated left ventricular changes.
• To explore the etiological factors contributing to this clinical triad in pediatric patients.

Main Methods:

• Long-term clinical observations of over 80 children diagnosed with meso-telesystolic clicks.
• Analysis of the correlation between clinical findings and pathological alterations in the posterio-phrenic portion of the left ventricle.

Main Results:

• A consistent association was found between meso-telesystolic clicks, late systolic murmurs, and alterations in the posterio-phrenic left ventricle.
• Congenital maldevelopment, inflammation, fibrotic processes, and rheumatic heart disease were identified as potential causative factors.
• Extracardiac origins, such as pleuropericardiac adhesions, are rare causes of systolic clicks.

Conclusions:

• The triad of meso-telesystolic click, late systolic murmur, and left ventricular changes likely stems from a single intracardiac pathogenetic mechanism.
• These findings, indicative of mild to moderate mitral insufficiency, typically carry a favorable prognosis in pediatric cases.