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Squatting and handgrip both increase systemic vascular resistance BUT why MVP intensity increase in handgrip and decrease in squatting?
 

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The only digestible answer I've found to that question was in uworld.
It says increase in afterload causes "better anatomical alignment" of the floppy mitral valve leaflets so the regurgitation is actually minimized, and so is the murmur.
However if the prolapse is too severe, this whole thing doesn't happen and murmur increases with increased afterload (just like in MR).
 
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