USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

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What pathology is suggested by a midsystolic "click" in auscultation of the heart?

  1. Coarctation of the aorta

  2. Patent ductus arteriosus

  3. Mitral regurgitation

  4. Systolic heart failure

The correct answer is: Mitral regurgitation

A midsystolic "click" in auscultation of the heart is associated with mitral valve prolapse, which is a common cause of mitral regurgitation. The click sound occurs when the valve leaflets billow into the left atrium during systole, causing a characteristic clicking sound. This is different from a systolic ejection click, which would suggest valvular or subvalvular stenosis, as in choices A and B. Choice D is incorrect because systolic heart failure would present with a different pattern of symptoms and sounds on auscultation.

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