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Mitral Prolapse: An Old Mysterious Entity - The Incremental Role of Multimodality Imaging in Sports Eligibility

Andreina Carbone1, Antonello D'Andrea1, Giancarlo Scognamiglio1

  • 1Luigi Vanvitelli University, Monaldi Hospital, AORN Ospedali Dei Colli, Naples, Italy.

Journal of Cardiovascular Echography
|February 13, 2019
PubMed

Insights

Mitral valve prolapse, though often benign, can cause serious complications like sudden cardiac death in athletes. Annual evaluations and advanced imaging are crucial for managing risks in affected individuals.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Sports Medicine

Background:

  • Mitral valve prolapse (MVP) is a common cardiac condition with fibromyxomatous changes, often benign but associated with significant complications.
  • Despite being a well-known entity, MVP presents diagnostic and management challenges, particularly concerning its link to sudden cardiac death (SCD) in athletes.
  • Fibrosis in papillary muscles and the left ventricle in MVP patients suggests a potential mechanism for fatal ventricular arrhythmias.

Purpose of the Study:

  • To review the diagnostic and clinical management complexities of mitral valve prolapse.
  • To highlight the association between mitral valve prolapse and sudden cardiac death in young athletes.
  • To discuss the role of multimodality imaging in evaluating cardiovascular risks and managing MVP.

Main Methods:

  • Literature review of mitral valve prolapse diagnosis, complications, and management strategies.
  • Analysis of recent studies investigating the pathophysiology of arrhythmias in MVP.
  • Evaluation of current guidelines for risk assessment in athletes with MVP and mitral regurgitation (MR).

Main Results:

  • Mitral valve prolapse can lead to serious complications including mitral regurgitation, arrhythmias, heart failure, and sudden cardiac death.
  • MVP is a significant contributor to sudden cardiac death in young competitive athletes.
  • Annual evaluations including physical exams, echocardiography, and stress testing are recommended for athletes with MVP and MR.

Conclusions:

  • Mitral valve prolapse requires careful clinical management due to potential severe complications, especially in athletes.
  • Multimodality imaging, including echocardiography, cardiac MRI, and CT, is essential for comprehensive diagnosis and management.
  • Risk stratification and regular monitoring are critical for athletes diagnosed with mitral valve prolapse and mitral regurgitation.
Keywords:
Athletescardiac magnetic resonanceechocardiographymitral valve prolapsesport eligibility

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