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Mitral Valve Prolapse II: Assessment and Management

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.

Mitral Stenosis II: Clinical features and Diagnostic Tests

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Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...

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Related Experiment Video

Updated: May 12, 2026

Quantitative Autonomic Testing

Quantitative Autonomic Testing

Published on: July 19, 2011

Modified Valsalva test differentiates primary from secondary cough headache.

Russell J M Lane¹, Paul T G Davies

¹Charing Cross Hospital, Imperial College, London, UK. r.lane@imperial.ac.uk

The Journal of Headache and Pain

|April 10, 2013

Summary

The Valsalva test helps distinguish primary cough headache from secondary cough headache, often caused by posterior fossa issues. This aids in diagnosing and treating this specific headache type.

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Last Updated: May 12, 2026

Quantitative Autonomic Testing

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Software for Analysis of Heart Rate and Blood Pressure Time-series Data from the Valsalva Maneuver

Software for Analysis of Heart Rate and Blood Pressure Time-series Data from the Valsalva Maneuver

Published on: June 27, 2025

Area of Science:

Neurology
Neuroscience
Diagnostic Medicine

Background:

Cough headache is typically defined by Valsalva maneuver provocation, assumed to be due to increased intracranial pressure.
This study questions the universal applicability of this assumption and explores the Valsalva test's utility in differentiating primary and secondary cough headache.

Purpose of the Study:

To investigate the efficacy of a modified Valsalva test in distinguishing between primary and secondary cough headache.
To explore the underlying mechanisms of different cough headache types.

Main Methods:

Sixteen consecutive patients with cough headache underwent a modified Valsalva test.
Brain MRI was performed on all patients to identify structural abnormalities.
A positive Valsalva test was defined as headache provocation during the maneuver.

Main Results:

Eleven patients had a positive modified Valsalva test, with ten diagnosed with posterior fossa pathologies (Chiari Type 1, meningiomas).
Surgery relieved cough headache in all patients with confirmed posterior fossa pathologies.
Five patients with negative or equivocal Valsalva tests and normal MRI were classified with primary cough headache.

Conclusions:

The modified Valsalva test can differentiate secondary cough headache, often linked to cerebrospinal fluid dynamic obstructions, from primary cough headache.
Findings suggest primary cough headache may involve venous congestion and trigeminal nerve sensitivity, distinct from secondary causes.
The Valsalva test can help determine if tonsillar herniation on MRI is symptomatic.