In MVP, you would except the ejection click to be more accentuated and the murmur to move closer the first heart sound in a patient
Anxiety, with an increase in heart rate or decreasing venous return to the heart (standing), causes the click and murmur to occur earlier in systole (closer to S1). Lying down, squatting, sustained hand grip exercise, or passive leg lifting in the supine position increase venous return and cause the click and murmur to occur later in systole (less gravity and more venous return). The diagnosis is best made by echocardiogra­phy. -adrenergic blocking agents are frequently used for treatment of supraventricular tachycardias. Cal­cium channel blockers are also used in symptomatic cases.
With marked anxiety
Who is pregnant
Who is passive leg lifting in the supine position
On a beta blocker